Increased Cup Anteversion May Not Prevent Posterior Dislocation in Patients With Abnormal Spinopelvic Characteristics in Total Hip Arthroplasty

Grosso, Matthew J.; Plaskos, Christopher; Pierrepont, Jim; Saxena, Arjun

doi:10.1016/j.artd.2023.101192

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…However, the historical Lewinnek safe zone[ 43 ], which had been considered the optimal acetabular position for decades, has been shown to be inadequate, and the ideal orientation of the socket seems to be patient-specific[ 87 - 89 ]. In a clinical and radiographic study, Grosso et al [ 90 ] showed that in a dislocating cohort, a decreased percentage of cups were within the safe zone, and an increased cup anteversion alone may not prevent posterior instability in patients with abnormal spinopelvic characteristics.…”

Section: Discussionmentioning

confidence: 99%

Dislocation of primary total hip arthroplasty: Analysis of risk factors and preventive options

Regis,

Cason,

Magnan

2024

World J Orthop

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Total hip arthroplasty (THA) is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint disease. However, dislocation continues to be a troublesome complication after THA, as it is a leading cause of revision and is associated with substantial social, health, and economic costs. It is a relatively rare, usually early occurrence that depends on both the patients’ characteristics and the surgical aspects. The most recent and important finding is the special attention to be given preoperatively to spinopelvic mobility, which is closely related to the incidence of dislocation. Consequently, clinical and radiographic assessment of the lumbar spine is mandatory to identify an altered pelvic tilt that could suggest a different positioning of the cup. Lumbar spinal fusion is currently considered a risk factor for dislocation and revision regardless of whether it is performed prior to or after THA. Surgical options for its treatment and prevention include the use of prostheses with large diameter of femoral head size, dual mobility constructs, constrained liners, and modular neck stems.

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