Anatomical Hip Range of Motion After Implantation During Total Hip Arthroplasty With a Large Change in Pelvic Inclination

Miki, Hirokazu; Kyo, Takayuki; Sugano, Nobuhiko

doi:10.1016/j.arth.2012.03.002

Cited by 49 publications

(36 citation statements)

References 25 publications

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“…In accordance with several other studies, 14,17,18 dPT was < 10° for the majority of patients (41 of 47). Similarly, change in the standing pelvic tilt after THR was small for 32 of 34 patients (94%).…”

Section: Discussionsupporting

confidence: 92%

Functional acetabular component position with supine total hip replacement

Eilander

Harris

Henkus

et al. 2013

The Bone & Joint Journal

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Orientation of the acetabular component influences wear, range of movement and the incidence of dislocation after total hip replacement (THR). During surgery, such orientation is often referenced to the anterior pelvic plane (APP), but APP inclination relative to the coronal plane (pelvic tilt) varies substantially between individuals. In contrast, the change in pelvic tilt from supine to standing (dPT) is small for nearly all individuals. Therefore, in THR performed with the patient supine and the patient's coronal plane parallel to the operating table, we propose that freehand placement of the acetabular component placement is reliable and reflects standing (functional) cup position. We examined this hypothesis in 56 hips in 56 patients (19 men) with a mean age of 61 years (29 to 80) using three-dimensional CT pelvic reconstructions and standing lateral pelvic radiographs. We found a low variability of acetabular component placement, with 46 implants (82%) placed within a combined range of 30° to 50° inclination and 5° to 25° anteversion. Changing from the supine to the standing position (analysed in 47 patients) was associated with an anteversion change < 10° in 45 patients (96%). dPT was < 10° in 41 patients (87%). In conclusion, supine THR appears to provide reliable freehand acetabular component placement. In most patients a small reclination of the pelvis going from supine to standing causes a small increase in anteversion of the acetabular component.

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Section: Discussionsupporting

confidence: 92%

Functional acetabular component position with supine total hip replacement

Eilander

Harris

Henkus

et al. 2013

The Bone & Joint Journal

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“…12,22,27 Recent studies have highlighted the concept of the functional orientation of the acetabular component, which is based on the FCP. 12,[27][28][29] These studies reported that the APP is not useful when it is used without considering the pelvic tilt, and could lead to complications. Miki et al 28 reported that the FCP is adequate for planning the position of the acetabular component, whether the pelvic tilt is small or large.…”

Section: Intra-observer Reliabilitymentioning

confidence: 99%

An analysis of the best method for evaluating anteversion of the acetabular component after total hip replacement on plain radiographs

Nomura

Naito

Nakamura

et al. 2014

The Bone & Joint Journal

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Several radiological methods of measuring anteversion of the acetabular component after total hip replacement (THR) have been described. These studies used different definitions and reference planes to compare methods, allowing for misinterpretation of the results. We compared the reliability and accuracy of five current methods using plain radiographs (those of Lewinnek, Widmer, Liaw, Pradhan, and Woo and Morrey) with CT measurements, using the same definition and reference plane. We retrospectively studied the plain radiographs and CT scans in 84 hips of 84 patients who underwent primary THR. Intra- and inter-observer reliability were high for the measurement of inclination and anteversion with all methods on plain radiographs and CT scans. The measurements of inclination on plain radiographs were similar to the measurements using CT (p = 0.043). The mean difference between CT measurements was 0.6° (-5.9° to 6.8°). Measurements using Widmer's method were the most similar to those using CT (p = 0.088), with a mean difference between CT measurements of -0.9° (-10.4° to 9.1°), whereas the other four methods differed significantly from those using CT (p < 0.001). This study has shown that Widmer's method is the best for evaluating the anteversion of the acetabular component on plain radiographs.

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“…Additionally, in three-dimensional planning using preoperative computed tomography (CT) images of the pelvis, several authors recommend using the pelvic plane in the supine position as the reference pelvic plane in most cases [4,5]. However, when a precise cup orientation is obtained at the time of THA, the functional cup inclination and anteversion will change if the pelvis tilts after THA [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%