Are Acetabular Component Alignment Guides for Total Hip Arthroplasty Accurate?

Minoda, Yukihide; Ohzono, Kenji; Aihara, Masaharu; Umeda, Naoya; Tomita, Masuhiro; Hayakawa, Keiko

doi:10.1016/j.arth.2009.07.016

Cited by 22 publications

(12 citation statements)

References 13 publications

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“…Third, we only tested one alignment guide and hence results may not be generalizable to other guides. However, Minoda et al 21 showed comparable ability of the tested guide compared with other guides in the market. Fourth, this study tested the ability of surgeons to estimate angles, not necessarily the ability to obtain the ideal cup position.…”

Section: Discussionmentioning

confidence: 90%

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Surgeons’ Accuracy in Achieving Their Desired Acetabular Component Orientation

Grammatopoulos

Alvand

Monk

et al. 2016

The Journal of Bone and Joint Surgery

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Section: Discussionmentioning

confidence: 90%

“…This task uses the alignment device with the impactor to achieve the predetermined orientation of the device relative to the pelvic plane and axis of the table. The alignment guide is an X-bar type with a predetermined angle of 45°inclination and 20°anteversion 21,22 .…”

Section: Task 4: Instrumented Cup Placement (Replicating Alignment Gumentioning

confidence: 99%

Surgeons’ Accuracy in Achieving Their Desired Acetabular Component Orientation

Grammatopoulos

Alvand

Monk

et al. 2016

The Journal of Bone and Joint Surgery

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show abstract

“…Mechanical guides (Minoda et al 2010) are the most popular instruments for determining cup orientation; however, the accuracy achieved with their use is not high enough to eliminate outliers—those not within 10° of the target angle. The TAL has been reported by several authors to provide an anatomical landmark for referencing cup orientation during THA (Archbold et al 2006, 2008, Pearce et al 2008, Mihalko et al 2009).…”

Section: Discussionmentioning

confidence: 99%

“…The use of a mechanical guide for cup implantation may give inaccurate results because of pelvic rotation on the operating table (Sugano et al 2007, Minoda et al 2010). …”

mentioning

confidence: 99%

Is the transverse acetabular ligament a reliable cup orientation guide?

Abe¹,

Sakai²,

Hamasaki³

et al. 2012

Acta Orthopaedica

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Background and purpose It is controversial whether the transverse acetabular ligament (TAL) is a reliable guide for determining the cup orientation during total hip arthroplasty (THA). We investigated the variations in TAL anatomy and the TAL-guided cup orientation.Methods 80 hips with osteoarthritis secondary to hip dysplasia (OA) and 80 hips with osteonecrosis of the femoral head (ON) were examined. We compared the anatomical anteversion of TAL and the TAL-guided cup orientation in relation to both disease and gender using 3D reconstruction of computed tomography (CT) images.Results Mean TAL anteversion was 11° (SD 10, range –12 to 35). The OA group (least-square mean 16°, 95% confidence interval (CI): 14–18) had larger anteversion than the ON group (least-square mean 6.2°, CI: 3.8 – 7.5). Females (least-square mean 20°, CI: 17–23) had larger anteversion than males (least-square mean 7.0°, CI: 4.6–9.3) in the OA group, while there were no differences between the sexes in the ON group. When TAL was used for anteversion guidance with the radiographic cup inclination fixed at 40°, 39% of OA hips and 9% of ON hips had more than 10° variance from the target anteversion, which was 15°.Interpretation In ON hips, TAL is a good guide for determining cup orientation during THA, although it is not a reliable guide in hips with OA secondary to dysplasia. This is because TAL orientation has large individual variation and is influenced by disease and gender.

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“…The supine position can provide a more predictable pelvic orientation, particularly when using uoroscopy to check the position of the pelvis and acetabular implants during surgery. Further, the acetabular alignment guide is not always accurate [21,22]. Minoda Intraoperative uoroscopy may play a critical role in in uencing cup position.…”

Section: Discussionmentioning

confidence: 99%

Direct Anterior Versus Anterolateral and Posterior Approaches to Total Hip Replacement: Comparative Accuracy of Acetabular Implant Placement and Early Clinical Outcomes

Chen¹,

Horng²,

Hsieh³

et al. 2020

Preprint

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BackgroundDifferent surgical approaches used in total hip arthroplasty (THA) include a direct anterior approach (DAA), anterolateral approach (AL), and posterolateral approach (PL). However, the acetabular cup position varies according to surgical view, surgical table, and patient position for each approach. This study is aimed to compare acetabular cup position in THA under different approaches, including surgical time, blood loss, and postoperative complications.MethodsBetween Jan 2017 and Dec 2018, 231 patients who underwent THA (64 DAA, 96 AL, and 71 PL THAs) were analyzed retrospectively. Intraoperative blood loss, operation time, preoperative and postoperative WOMAC score, cup anteversion, inclination angle, and postoperative complications were analyzed.ResultsDAA showed longer operation time and more blood loss, but shorter hospital stays. The cup was found in the safe zone for 97% of DAA patients, 74% of AL patients, and 56% of PL patients. PL showed the highest complication rate (9.9%), followed by DAA (3.1%) and AL (1%). There was no statistically significant difference in preoperative and postoperative WOMAC scores. ConclusionTHA by DAA using a special table is a more reliable procedure to achieve safe cup position. Although DAA showed fewer outliers in cup position, it resulted in longer operation time and greater blood loss compared to other groups.Trial registration: Retrospective study

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Are Acetabular Component Alignment Guides for Total Hip Arthroplasty Accurate?

Cited by 22 publications

References 13 publications

Surgeons’ Accuracy in Achieving Their Desired Acetabular Component Orientation

Surgeons’ Accuracy in Achieving Their Desired Acetabular Component Orientation

Is the transverse acetabular ligament a reliable cup orientation guide?

Direct Anterior Versus Anterolateral and Posterior Approaches to Total Hip Replacement: Comparative Accuracy of Acetabular Implant Placement and Early Clinical Outcomes

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