Accuracy of cup placement in total hip arthroplasty by means of a mechanical positioning device: a comprehensive cadaveric 3d analysis of 16 specimens

Kievit, Arthur J.; Dobbe, Johannes G. G.; Mallee, Wouter H.; Blankevoort, Leendert; Streekstra, Geert J.; Schafroth, Matthias U.

doi:10.1177/1120700019874822

Cited by 5 publications

(2 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More complex mechanical devices using anterior pelvic plane have been tested in cadavers. 15 They also found it helpful to increase the accuracy in positioning of the acetabular cup, but uses of such devices have their own drawbacks like increased surgery time and complications associated with reference pin placement. Similarly MRIbased patient-specific instrumentation guide have been used during THA.…”

Section: Discussionmentioning

confidence: 99%

Validation of use of transverse acetabular ligament and mechanical angle guide device to orient the acetabular cup

Agarwal

Pawar

Singh

et al. 2020

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

Aim: To verify if transverse acetabular ligament (TAL) can be used as an anatomical landmark to reliably orient the cup in primary total hip arthroplasty and compare it to acetabular cups placed with the help of mechanical angle guide (MAG) device. Materials and methods: Thirty Five patients with primary total hip arthroplasty, all performed by the same surgeon were included in the study. All patients had undergone surgery by anterolateral approach and all were cementless total hip arthroplasty. TAL was used as a reference guide for positioning of the cup in one group while MAG device was used in the other. Post operatively CT was done to confirm the version and inclination of the acetabular cup and the femoral stem version. SPSS was used for statistical analysis. Results: 18 males and 17 females were included. The most common etiological cause for THR was secondary osteoarthritis due to AVN (40%). At 18 months follow up, there was just 1 case of dislocation in group in which angle guide device was used. The mean anteversion of the acetabular cup on CT findings was 23.82 by using TAL while 18.35 with help of MAG device (P < 0.05). All were within Leweniks safe zone. Conclusions: The TAL and MAG device both can be effectively used to align the acetabulum component. TAL is patient specific intraoperative landmark which is not affected by patient positioning while angle guide device can give false positive assessment of cup version.

show abstract

Section: Discussionmentioning

confidence: 99%

Validation of use of transverse acetabular ligament and mechanical angle guide device to orient the acetabular cup

Agarwal

Pawar

Singh

et al. 2020

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

show abstract

“…However, the popularity of this technique has decreased due to its complexity and increase in operation time. A mechanical device pinpointing the anterior pelvic plane to optimize acetabular component placement was developed by Kievit et al, who found that it improved positioning with respect to the Lewinnek’s safe zones; however, this device has not been proven to work in the clinical setting [ 15 ]. Perioperative imageless techniques use infrared optical stereoscopy that allows for three-dimensional tracking of the prosthetic components and tools.…”

Section: Introductionmentioning

confidence: 99%

Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation Study

et al. 2022

View full text Add to dashboard Cite

Background and Objectives: Intraoperative fluoroscopy can be used to increase the accuracy of the acetabular component positioning during total hip arthroplasty. However, given the three-dimensional nature of cup positioning, it can be difficult to accurately assess inclination and anteversion angles based on two-dimensional imaging. The purpose of this study is to validate a novel method for calculating the 3D orientation of the acetabular cup from 2D fluoroscopic imaging. Materials and Methods: An acetabular cup was implanted into a radio-opaque pelvis model in nine positions sequentially, and the inclination and anteversion angles were collected in each position using two methods: (1) a coordinate measurement machine (CMM) was used to establish a digitalized anatomical coordinate frame based on pelvic landmarks of the cadaveric specimen, and the 3D position of the cup was then expressed with respect to the anatomical planes; (2) AP radiographic images were collected, and a mathematical formula was utilized to calculate the 3D inclination and anteversion based on the 2D images. The results of each method were compared, and interrater and intrarater reliably of the 2D method were calculated. Results: Interrater reliability was excellent, with an interclass correlation coefficient (ICC) of 0.988 (95% CI 0.975–0.994) for anteversion and 0.997 (95% CI 0.991–0.999) for inclination, as was intrarater reliability, with an ICC of 0.995 (95% CI 0.985–0.998) for anteversion and 0.998 (95% CI 0.994–0.999) for inclination. Intermethod accuracy was excellent with an ICC of 0.986 (95% CI: 0.972–0.993) for anteversion and 0.993 (95% CI: 0.989–0.995) for inclination. The Bland–Altman limit of agreement, which represents the error between the 2D and 3D methods, was found to range between 2 to 5 degrees. Conclusions: This data validates the proposed methodology to calculate 3D anteversion and inclination angles based on 2D fluoroscopic images to within five degrees. This method can be utilized to improve acetabular component placing intraoperatively and to check component placement postoperatively.

show abstract

The role of femoral head size in metal-on-metal hip arthroplasty: analysis of a cohort of 3813 patients with long term follow-up

Ciatti,

Andriollo,

Asti

et al. 2024

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Metal-on-metal (MoM) large headed arthroplasties were suggested to decrease failure rates by means of reduced volumetric wear and enhanced implant stability. However, they caused high rates of revisions due to adverse reaction to metal debris, osteolysis, pseudotumor growth, and other issues. The study aims to present the long-term outcomes of MoM arthroplasties on a large cohort of patients, evaluating the impact of head sizes on survival rate. All data were retrieved from the regional joint register (Registro dell’Implantologia Protesica Ortopedica, RIPO, Italy). We include in the study all patient who underwent cementless MoM total hip arthroplasties (THAs) between 2000 and 2020, dividing them in two subgroups according to head size (<36 mm, ≥36 mm). Failures were recorded up to December 31, 2020. Patients lost to follow-up were excluded. A total of 3813 THAs met the inclusion/exclusion criteria. The average follow-up period is 12.4 years (0–21 years). 178/1625 (or 11.0%) small head MoM THAs and 265/2188 large head ones failed by the end of follow up. Large diameter heads reported lower survival rate (p-value < 0.001), with unexpected higher dislocation rate (1.0 vs. 0.4%). Moreover, large head size was found to increases the risk of metallosis (p-value < 0.0001). Gender, patient’s age and the use of modular neck were not correlated with higher failure rates. MoM implants implants do not have the same reliability as other couplings, considering the significantly greater failure/complication rates. However, the knowledge of risks linked to head size is fundamental for establishing the right type of follow-up to the patient and recognize any complications early.

show abstract

Accuracy of cup placement in total hip arthroplasty by means of a mechanical positioning device: a comprehensive cadaveric 3d analysis of 16 specimens

Cited by 5 publications

References 34 publications

Validation of use of transverse acetabular ligament and mechanical angle guide device to orient the acetabular cup

Validation of use of transverse acetabular ligament and mechanical angle guide device to orient the acetabular cup

Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation Study

The role of femoral head size in metal-on-metal hip arthroplasty: analysis of a cohort of 3813 patients with long term follow-up

Contact Info

Product

Resources

About