Modern cup alignment techniques in total hip arthroplasty: A systematic review

Maillot, Cédric; Harman, Ciara; Villet, Loïc; Cobb, Justin P.; Rivière, Charles

doi:10.1016/j.otsr.2019.03.015

Cited by 45 publications

(34 citation statements)

References 32 publications

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“…However, the dichotomization of continuous variables creates multiple problems including the comparability of the results and is generally not recommended 54 , 55 . The concept of a unified safe zone for all patients has been questioned and a patient-specific target zone has been proposed in the last decade 5 , 9 , 56 , 57 . In this context, the division of the patients into two or multiple subgroups based on the SOP or change of SOP is questionable and, instead of choosing a more or less unrelated threshold such as 10° 25 , 47 , 58 , dichotomization should be avoided.…”

Section: Discussionmentioning

confidence: 99%

“…Functional component alignment in total hip arthroplasty (THA) is crucial to reduce the incidence of early revision surgery 1 – 5 . The functional cup orientation refers to the target alignment of the cup relative to the femoral component and the pelvic bone, reducing the risk of edge-loading, accelerated wear, impingement and dislocation for weight-bearing functional activities of daily living 6 – 10 .…”

Section: Introductionmentioning

confidence: 99%

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Preoperative factors improving the prediction of the postoperative sagittal orientation of the pelvis in standing position after total hip arthroplasty

Fischer

Tokunaga

Okamoto

et al. 2020

Sci Rep

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The aims of this study were to investigate if the sagittal orientation of the pelvis (SOP) in the standing position changes after total hip arthroplasty (THA) and evaluate what preoperative factors may improve the prediction of the postoperative standing SOP in the context of a patient-specific functional cup orientation. 196 primary THA patients from Japan were retrospectively selected for this study. Computed tomography imaging of the pelvis, EOS imaging of the lower body and lateral radiographs of the lumbar spine in the standing position were taken preoperatively. Common biometrics and preoperative Harris Hip Score were recorded. The EOS imaging in the standing position was repeated three months following THA. A 3D/2.5D registration process was used to determine the standing SOP. Thirty-three preoperative biometric, morphological and functional parameters were measured. Important preoperative parameters were identified that significantly improve the prediction of the postoperative standing SOP by using multiple linear LASSO regression. On average, the SOP changed significantly (p < 0.001) between the preoperative and postoperative standing position three months after THA by 3° ± 4° in the posterior direction. The age, standing lumbar lordosis angle (LLA) and preoperative supine and standing SOP significantly (p < 0.001) improve the prediction of the postoperative standing SOP. The linear regression model for the prediction of the postoperative standing SOP is significantly (p < 0.001) improved by adding the parameters preoperative standing SOP and LLA, in addition to the preoperative supine SOP, reducing the root mean square error derived from a leave-one-out cross-validation by more than 1°. The mean standing SOP in Japanese patients changes already three months after THA in comparison to the preoperative value. The preoperative factors age, LLA, supine and standing SOP can significantly improve the prediction of the postoperative standing SOP and should be considered within the preoperative planning process of a patient-specific functional cup orientation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preoperative factors improving the prediction of the postoperative sagittal orientation of the pelvis in standing position after total hip arthroplasty

Fischer

Tokunaga

Okamoto

et al. 2020

Sci Rep

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show abstract

“…PI could be used to predict the adaptability of PT and SS regarding their changes in sitting and standing positions, which was not readily recognized by hip surgeon [ 14 , 32 ]. The change of PT and SS is essential in that they determine the hip-spine relationship between different positions and that they are essential to the management of acetabular cup [ 33 ]. For example, a large PI-LL mismatch or large SS or LL loss could negatively affect the functional anteversion ranges at different positions [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

The severity of developmental dysplasia of the hip does not correlate with the abnormality in pelvic incidence

Cheng

Huang

Kernkamp

et al. 2020

BMC Musculoskelet Disord

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Background The purpose of this study was to investigate the association between the severity of Developmental dysplasia of the hip (DDH) and the abnormality in pelvic incidence (PI). Methods This was a retrospective study analyzing 53 DDH patients and 53 non-DDH age-matched controls. Computed tomography images were used to construct three-dimensional pelvic model. The Crowe classification was used to classify the severity of DDH. The midpoint of the femoral head centers and sacral endplates were projected to the sagittal plane of the pelvis. The PI was defined as the angle between a line perpendicular to the sacral plate at its midpoint and a line connecting this point to the axis of the femoral heads. Independent sample t-tests were used to compare the differences between the PI of DDH group and the non-DDH controls group. Kendall’s coefficient of concordance was used to determine the correlation between the severity of DDH and PI. Results Patients with DDH had a significantly (p = 0.041) higher PI than the non-DDH controls (DDH 47.6 ± 8.2°, normal 44.2 ± 8.8°). Crowe type I patients had a significantly (p = 0.038) higher PI (48.2 ± 7.6°) than the non-DDH controls. No significant difference between the PI in Crowe type II or III patients and the PI in non-DDH controls were found (Crowe type II, 50.2 ± 9.6°, p = 0.073; Crowe type III, 43.8 ± 7.2°, p = 0.930). No correlation was found between the severity of DDH and the PI (r = 0.091, p = 0.222). Conclusions No correlation was found between the severity of DDH and the PI. The study confirmed that the PI in DDH (Crowe type I) group was higher than that of the non-DDH control group, while the PI does not correlate with the severity of DDH.

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“…Seit Beginn des 21. Jahrhunderts wurden zunehmend bildfreie Navigation oder roboterunterstützte Implantationssysteme eingesetzt, welche eine sichere und akzeptable Pfannenpositionierung zu gewährleisten scheinen [30,36,50]. Allerdings konnten für diese Techniken keine Vorteile bezüglich klinischem Outcome und Überlebensrate nacheinem 10-Jahres-Follow-up gezeigt werden [37].…”

Section: Einfluss Des Spinopelvinen Alignements Auf Die Hüfttotalendounclassified

Hip-Spine-Syndrom – Aktuelle Entwicklungen und Evidenzlage

et al. 2020

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Zusammenfassung Das physiologische Zusammenspiel von Wirbelsäule, Becken und Hüfte gewährleistet ein Gleichgewicht zwischen dem Rumpf und der Hüfte bei Alltagaktivitäten, wie z. B. dem Stehen und Sitzen. Die degenerativen Veränderungen oder Spondylodese der Wirbelsäule reduzieren die Beckenbeweglichkeit und können nach einem endoprothetischen Hüftgelenksersatz zu einer erhöhten Luxationsrate führen. Um die Risikopatienten zu identifizieren und die Luxationsraten zu reduzieren, wurden kürzlich von verschiedenen Autoren funktionelle Wirbelsäulen- und Beckenaufnahmen sowie individuelle Zielzonen für die Komponentenorientierung empfohlen. Das Ziel dieser Arbeit ist es, die derzeitige Datenlage bezüglich des spinopelvinen Alignements und dessen Rolle in der Hüftendoprothetik und mögliche Ableitungen für den Klinikalltag kritisch darzustellen.

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Modern cup alignment techniques in total hip arthroplasty: A systematic review

Cited by 45 publications

References 32 publications

Preoperative factors improving the prediction of the postoperative sagittal orientation of the pelvis in standing position after total hip arthroplasty

Preoperative factors improving the prediction of the postoperative sagittal orientation of the pelvis in standing position after total hip arthroplasty

The severity of developmental dysplasia of the hip does not correlate with the abnormality in pelvic incidence

Hip-Spine-Syndrom – Aktuelle Entwicklungen und Evidenzlage

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