Sagittal spinopelvic alignment predicts hip function after total hip arthroplasty

Ochi, Hironori; Homma, Yasuhiro; Baba, Tomonori; Nojiri, Hidetoshi; Matsumoto, M

doi:10.1016/j.gaitpost.2016.12.010

Cited by 42 publications

(45 citation statements)

References 35 publications

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“… 52 , 53 Patients with one of these aforementioned abnormal types of pelvic kinematics or an abnormally low pelvic incidence (< 35°) are therefore affected by a clinically deleterious lumbopelvic stiffness. 54 - 60 This generates aberrant functional acetabular orientation in sitting/squatting 9 , 47 - 51 , 61 or standing positions. 59 , 62 A compensatory effect by the use of a larger hip range of motion makes these patients ‘hip users’ 9 ( Fig.…”

Section: Personalized Techniques For Total Joint Replacement: the Kinmentioning

confidence: 99%

Kinematic alignment technique for total hip and knee arthroplasty

Rivière

Lazic

Villet³

et al. 2018

EFORT Open Reviews

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Conventional techniques for hip and knee arthroplasty have led to good long-term clinical outcomes, but complications remain despite better surgical precision and improvements in implant design and quality.Technological improvements and a better understanding of joint kinematics have facilitated the progression to ‘personalized’ implant positioning (kinematic alignment) for total hip (THA) and knee (TKA) arthroplasty, the true value of which remains to be determined.By achieving a true knee resurfacing, the kinematic alignment (KA) technique for TKA aims at aligning the components with the physiological kinematic axes of the knee and restoring the constitutional tibio-femoral joint line frontal and axial orientation and soft-tissue laxity.The KA technique for THA aims at restoring the native ‘combined femoro-acetabular anteversion’ and the hip’s centre of rotation, and occasionally adjusting the cup position and design based on the assessment of the individual spine-hip relation.The key element for optimal prosthetic joint kinematics (hip or knee) is to reproduce the femoral anatomy.The transverse acetabular ligament (TAL) is the reference landmark to adjust the cup position.Cite this article: EFORT Open Rev 2018;3:98-105. DOI: 10.1302/2058-5241.3.170022

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Section: Personalized Techniques For Total Joint Replacement: the Kinmentioning

confidence: 99%

Kinematic alignment technique for total hip and knee arthroplasty

Rivière

Lazic

Villet³

et al. 2018

EFORT Open Reviews

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“… 2016 , Ochi et al. 2017 ) or that higher pelvic incidence may predispose or be otherwise connected to coxarthrosis (Yoshimoto et al. 2005 , Bredow et al.…”

mentioning

confidence: 99%

Pelvic incidence and hip disorders

Saltychev¹,

Pernaa

Seppänen

et al. 2017

Acta Orthopaedica

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Background and purposeThe role of pelvic incidence in hip disorders is unclear. Therefore, we undertook a literature review to evaluate the evidence on that role.MethodsA search was carried out on MEDLINE, SCOPUS, CENTRAL, and CINAHL databases. Quantitative analysis was based on comparison with a reference population of asymptomatic subjects.ResultsThe search resulted in 326 records: 15 studies were analyzed qualitatively and 13 quantitatively. The estimates of pelvic incidence varied more than 10 degrees from 47 (SD 3.7) to 59 (SD 14). 2 studies concluded that higher pelvic incidence might contribute to the development of coxarthrosis while 1 study reported the opposite findings. In 2 studies, lower pelvic incidence was associated with a mixed type of femoroacetabular impingement. We formed a reference population from asymptomatic groups used or cited in the selected studies. The reference comprised 777 persons with pooled average pelvic incidence of 53 (SD 10) degrees. The estimate showed a relatively narrow 95% CI of 52 to 54 degrees. The 95% CIs of only 4 studies did not overlap the CIs of reference: 2 studies on coxarthrosis, 1 on mixed femoroacetabular impingement, and 1 on ankylosing spondylitisInterpretationWe found no strong evidence that pelvic incidence plays any substantial role in hip disorders. Lower pelvic incidence may be associated with the mixed type of femoroacetabular impingement and hip problems amongst patients with ankylosing spondylitis. The evidence on association between pelvic incidence and coxarthrosis remained inconclusive.

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“… 53 , 54 In order to further understand the pathophysiology of prosthetic dislocation, it has been introduced the concept of functional acetabular orientation related to pelvic and lumbar mobility. 9 The Combined Sagittal Index (CSI) introduced by Heckmann et al , 23 has been proposed as a more predictive element for implants’ safety than coronal acetabular angles. It is obtained from the sum of cup anteinclination (AI) and PFA and it has been considered an effective tool in predicting the risk of anterior or posterior impingement in patients with abnormal hip-spine motion.…”

Section: Spine Disorders and Total Hip Arthroplastymentioning

confidence: 99%

Surgical implications of the hip-spine relationship in total hip arthroplasty

et al. 2020

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Total hip arthroplasty (THA) is considered the most successful orthopedic surgical procedure of the last century with excellent survivorship up to 20-years. However, instability remains a major issue representing the most common reason for revision after THA. Hip-spine relationship has gained progressive interest between arthroplasty surgeons and its understanding is crucial in order to identify high-risk patients for postoperative dislocation. Spinal deformity and abnormal spinopelvic mobility have been associated with increased risk for instability, dislocation and revision THA. Preoperative workup begins with standing anteroposterior pelvis x-ray and lateral spinopelvic radiographs in the standing and sitting position. Hip-spine stiffness needs to be addressed before THA in consideration of adapting the preoperative planning to the patient’s characteristics. Acetabular component should be implanted with different anteversion and inclination angles according to the pattern of hip-spine motion in order to reduce the risk of impingement and consequent dislocation. Different algorithmic approaches have been proposed in case of concomitant hip-spine disease and in case of altered sagittal balance and pelvic mobility. The aim of this review is to investigate and clarify the hip-spine relationships and evaluate the impact on modern total hip arthroplasty.

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Sagittal spinopelvic alignment predicts hip function after total hip arthroplasty

Cited by 42 publications

References 35 publications

Kinematic alignment technique for total hip and knee arthroplasty

Kinematic alignment technique for total hip and knee arthroplasty

Pelvic incidence and hip disorders

Surgical implications of the hip-spine relationship in total hip arthroplasty

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