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Cha MJ, Xi Y, Chhabra A, Pierrepont J, Jones T, Hohman D, Wells J. Variation in Functional Pelvic Tilt in Female Patients Undergoing Total Hip Arthroplasty With Acetabular Dysplasia. J Arthroplasty 2023; 38:2623-2629. [PMID: 37279848 DOI: 10.1016/j.arth.2023.05.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND As the pelvis is a dynamic structure, the quantification of pelvic tilt (PT) should be done in different hip positions prior to total hip arthroplasty (THA). We sought to investigate functional PT in young female patients undergoing THA and explore the correlation of PT with the extent of acetabular dysplasia. Additionally, we aimed to define the PS-SI (pubic symphysis-sacroiliac joint) index as a PT quantifier on AP pelvis X-ray. METHODS Pre-THA female patients under the age of 50 years (n = 678) were investigated. Functional PT in 3 positions (supine, standing, and sitting) were measured. Hip parameters including lateral center-edge angle (LCEA), Tönnis angle, head extrusion index (HEI), and femoro-epiphyseal acetabular roof (FEAR) index were correlated to PT values. The PS-SI/SI-SH (sacroiliac joint-sacral height) ratio was also correlated to PT. RESULTS From the 678 patients, 80% were classified as having acetabular dysplasia. Among these patients, 50.6% were bilaterally dysplastic. The mean functional PT of the entire patient group was 7.4°, 4.1°, and -1.3° in the supine, standing and seated positions. The mean functional PT of the dysplastic group was 7.4°, 4.0°, and -1.2° in the supine, standing and seated positions. The PS-SI/SI-SH ratio was found to be correlated to PT. CONCLUSION Most of the pre-THA patients had acetabular dysplasia and exhibited anterior PT in the supine and standing positions, most pronounced in the standing position. PT values were comparable between the dysplastic and non-dysplastic group without change with worsening dysplasia. PS-SI/SI-SH ratio can be used to easily characterize PT.
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Affiliation(s)
- Myung-Jin Cha
- University of Texas Rio Grande Valley, UT Southwestern Medical School, Dallas, Texas
| | - Yin Xi
- Department of Radiology and Population and Data Sciences, UT Southwestern Medical Center, Dallas, Texas
| | - Avneesh Chhabra
- Department of Radiology and Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, Texas
| | | | | | - Don Hohman
- Department of Orthopaedic Surgery, Medical City Dallas Texas, UT Southwestern Medical Center, Dallas, Texas
| | - Joel Wells
- Baylor Scott & White Comprehensive Hip Center and Hip Preservation Center, Texas A&M School of Medicine, Bryan, Texas
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Nie MD, Huang ZB, Zhang NZ, Fu LJ, Cheng CK. Biomechanical evaluation of a novel intervertebral disc repair technique for large box-shaped ruptures. Front Bioeng Biotechnol 2023; 11:1104015. [PMID: 36845190 PMCID: PMC9945520 DOI: 10.3389/fbioe.2023.1104015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/30/2023] [Indexed: 02/10/2023] Open
Abstract
Objective: The purpose of this study was to analyze the feasibility of repairing a ruptured intervertebral disc using a patch secured to the inner surface of the annulus fibrosus (AF). Different material properties and geometries for the patch were evaluated. Methods: Using finite element analysis, this study created a large box-shaped rupture in the posterior-lateral region of the AF and then repaired it with a circular and square inner patch. The elastic modulus of the patches ranged from 1 to 50 MPa to determine the effect on the nucleus pulposus (NP) pressure, vertical displacement, disc bulge, AF stress, segmental range of motion (ROM), patch stress, and suture stress. The results were compared against the intact spine to determine the most suitable shape and properties for the repair patch. Results: The intervertebral height and ROM of the repaired lumbar spine was similar to the intact spine and was independent of the patch material properties and geometry. The patches with a modulus of 2-3 MPa resulted in an NP pressure and AF stresses closest to the healthy disc, and produced minimal contact pressure on the cleft surfaces and minimal stress on the suture and patch of all models. Circular patches caused lower NP pressure, AF stress and patch stress than the square patch, but also caused greater stress on the suture. Conclusion: A circular patch with an elastic modulus of 2-3 MPa secured to the inner region of the ruptured annulus fibrosus was able to immediately close the rupture and maintain an NP pressure and AF stress similar to the intact intervertebral disc. This patch had the lowest risk of complications and produced the greatest restorative effect of all patches simulated in this study.
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Affiliation(s)
- Mao-Dan Nie
- School of Biomedical Engineering and Engineering Research Center of Digital Medicine of the Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Ze-Bin Huang
- Department of Spine Surgery, First Affiliated Hospital of Second Military Medical University, Shanghai, China
| | - Ning-Ze Zhang
- Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Ling-Jie Fu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Ling-Jie Fu, ; Cheng-Kung Cheng,
| | - Cheng-Kung Cheng
- School of Biomedical Engineering and Engineering Research Center of Digital Medicine of the Ministry of Education, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Ling-Jie Fu, ; Cheng-Kung Cheng,
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Fischer MCM, Tokunaga K, Okamoto M, Habor J, Radermacher K. Implications of the uncertainty of postoperative functional parameters for the preoperative planning of total hip arthroplasty. J Orthop Res 2022; 40:2656-2662. [PMID: 35266575 DOI: 10.1002/jor.25291] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 12/23/2021] [Accepted: 01/30/2022] [Indexed: 02/04/2023]
Abstract
The functional parameters pelvic tilt (PT) and hip joint force (HJF) are required to calculate patient-specific target zones based on the range of motion (ROM) and implant loading for preoperative planning of total hip arthroplasty (THA). Both functional parameters may change after THA. The preoperative prediction of the postoperative PT and HJF is associated with a specific amount of uncertainty. The prediction uncertainty has to be considered in the preoperative planning process to avoid a suboptimal implantation. So far, very little attention has been paid to the necessary reduction of patient-specific target zones by the prediction uncertainties of postoperative functional parameters. Prediction models for the postoperative PT in standing position and for the HJF during one-leg stance as a surrogate for the peak force phase during level walking were used to quantify the reduction of the ROM- and load-based target zones of 196 Japanese THA patients. The prediction uncertainty was about 14° for the postoperative standing PT and ranged from 17% body weight to 37% body weight for the components of the HJF. On average, the prosthetic ROM-based target zone had to be significantly reduced by 43% and the load-based target zone by 39%. This led to a median reduction of the combined prosthetic ROM- and load-based target zone of 96%. The study sharpens the awareness for the substantial reduction of ROM- and load-based target zones by prediction uncertainties of the postoperative PT and HJF and highlights the importance of further research to improve prediction models for both functional parameters.
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Affiliation(s)
- Maximilian C M Fischer
- Chair of Medical Engineering, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
| | - Kunihiko Tokunaga
- Niigata Hip Joint Center, Kameda Daiichi Hospital, Niigata City, Japan
| | - Masashi Okamoto
- Department of Radiology, Kameda Daiichi Hospital, Niigata City, Japan
| | - Juliana Habor
- Chair of Medical Engineering, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
| | - Klaus Radermacher
- Chair of Medical Engineering, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
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Hardwick-Morris M, Twiggs J, Kacker K, Miles B, Balakumar J. Functional Femoral Anteversion: Axial Rotation of the Femur and its Implications for Stem Version Targets in Total Hip Arthroplasty. Arthroplast Today 2022; 18:16-23. [PMID: 36267395 PMCID: PMC9576488 DOI: 10.1016/j.artd.2022.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/13/2022] [Accepted: 09/06/2022] [Indexed: 11/25/2022] Open
Abstract
Background Acetabular and femoral component positioning are important considerations in reducing adverse outcomes after total hip arthroplasty (THA). Previous assessments of femoral anteversion examined anatomic femoral anteversion (AFA) referenced to anatomic landmarks. However, this does not provide a functional understanding of the femur's relationship to the hip. We investigate a new measurement, functional femoral anteversion (FFA), and sought to measure its variability across a large sample of patients undergoing THA. Methods A total of 1008 consecutive patients underwent THA surgery between September 2019 and July 2021. All patients were measured for supine and standing functional femoral rotation (FFR), AFA, and FFA. Results The mean standing FFA was 13.2° ± 12.2° (-27.8° to 52.3°). The mean change in FFR from supine to standing was -2.2° ± 11.8° (-43.0° to 41.9°). Of all, 161 (16%) patients had standing FFA version greater than 25°. Four hundred sixty (46%) patients had standing FFR (internal or external) greater than 10°. One hundred twenty-three (12%) patients exhibited an increase in external rotation from supine to standing of greater than 10°. A moderate, negative linear relationship was observed between AFA and standing external femoral rotation (P <<.001, R = -0.46), indicating people may externally rotate their femur as AFA decreases with age. Conclusions Functional alignment of the femur in patients requiring THA is understudied. It is now understood that the femur, like the pelvis, can rotate substantially between functional positions. Enhancing our understanding of FFA and FFR may improve both acetabular and femoral component positioning.
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Affiliation(s)
- Max Hardwick-Morris
- Flinders University, Adelaide, South Australia, Australia,360 Med Care, Sydney, New South Wales, Australia,Corresponding author. 360 Med Care, Suite 3, Building 1/20 Bridge Street, Pymble, New South Wales, Australia. Tel.: +61 406 937 050.
| | | | | | - Brad Miles
- 360 Med Care, Sydney, New South Wales, Australia
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Thomas C, Gupta V, Parsons H, Metcalfe A, Foguet P, King R. Does functional planning, 3D templating and patient-specific instrumentation improve accuracy in total hip replacement?- a randomized controlled trial. ARTHROPLASTY (LONDON, ENGLAND) 2022; 4:43. [PMID: 36183111 PMCID: PMC9526907 DOI: 10.1186/s42836-022-00143-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/01/2022] [Indexed: 11/05/2022]
Abstract
AIMS Debate continues as to the optimal orientation of the acetabular component in total hip arthroplasty (THA) and how to reliably achieve this. The primary objective of this study was to compare functional CT-based planning and patient-specific instruments with conventional THA using 2D templating. METHODS A pragmatic single-center, patient-assessor blinded, randomized control trial of patients undergoing THA was performed. 54 patients (aged 18-70) were recruited to either Corin Optimized Positioning System (OPS) or conventional THA. All patients received a cementless acetabular component. All patients underwent pre- and postoperative CT scans, and four functional X-rays. Patients in the OPS group had a 3D surgical plan and bespoke guides made. Patients in the conventional group had a surgical plan based on 2D templating X-rays. The primary outcome measure was the mean error in acetabular anteversion as determined by postoperative CT scan. RESULTS There was no statistically significant difference in the mean error in angle of acetabular anteversion when comparing OPS and conventional THA. In the OPS group, the achieved acetabular anteversion was within 10° of the planned anteversion in 96% of cases, compared with only 76% in the conventional group. The clinical outcomes were comparable between the groups. CONCLUSION Large errors in acetabular orientation appear to be reduced when CT-based planning and patient-specific instruments are used compared to the standard technique but no significant differences were seen in the mean error.
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Affiliation(s)
- Christopher Thomas
- grid.15628.380000 0004 0393 1193University Hospitals Coventry & Warwickshire NHS Trust, Coventry, England ,grid.414081.80000 0004 0400 1166Present address: Dorset County Hospital, Williams Avenue, Dorchester, DT1 2JY UK
| | - Vatsal Gupta
- grid.15628.380000 0004 0393 1193University Hospitals Coventry & Warwickshire NHS Trust, Coventry, England
| | - Helen Parsons
- grid.7372.10000 0000 8809 1613University of Warwick, Coventry, England
| | - Andrew Metcalfe
- grid.15628.380000 0004 0393 1193University Hospitals Coventry & Warwickshire NHS Trust, Coventry, England ,grid.7372.10000 0000 8809 1613University of Warwick, Coventry, England
| | - Pedro Foguet
- grid.15628.380000 0004 0393 1193University Hospitals Coventry & Warwickshire NHS Trust, Coventry, England
| | - Richard King
- grid.15628.380000 0004 0393 1193University Hospitals Coventry & Warwickshire NHS Trust, Coventry, England
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Danaei B, McPhee J. Model-Based Acetabular Cup Orientation Optimization Based On Minimizing the Risk of Edge-Loading and Implant Impingement Following Total Hip Arthroplasty. J Biomech Eng 2022; 144:1141865. [PMID: 35748611 DOI: 10.1115/1.4054866] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Indexed: 11/08/2022]
Abstract
In this paper, a computationally-efficient model-based method for determining patient-specific optimal acetabular cup alignment for total hip arthroplasty (THA) is presented. The proposed algorithm minimizes the risk of implant impingement and edge-loading, which are reported as the major causes of hip dislocation following THA. First, by using motion capture data recorded from the patient performing different daily activities, the hip contact force and the relative orientation of the femur and pelvis are calculated by a musculoskeletal model. Then, by defining two quantitative indices i.e., angular impingement distance and angular edge-loading distance, the risk of impingement and edge-loading are assessed for a wide range of cup alignments. And finally, three optimization criteria are introduced to estimate the optimal cup alignment with a tradeoff between the risk of impingement and edge-loading. The results show that patient-specific characteristics such as pelvic tilt could significantly change the optimal cup alignment, especially the value of cup anteversion. Therefore, in some cases, the well-known Lewinnek safe zone may not be optimal, or even safe. Unlike other dynamic model-based methods, in this work, the need for force plate measurements is eliminated by estimating the ground reaction forces and moments, which makes this method more practical and cost-efficient. Furthermore, the low computational complexity due to analytical formulas makes this method suitable for both preoperative and intra-operative planning.
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Affiliation(s)
- Behzad Danaei
- Motion Research Group, Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - John McPhee
- Motion Research Group, Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
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Batra S, Khare T, Kabra AP, Malhotra R. Hip-spine relationship in total hip arthroplasty - Simplifying the concepts. J Clin Orthop Trauma 2022; 29:101877. [PMID: 35515342 PMCID: PMC9065712 DOI: 10.1016/j.jcot.2022.101877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022] Open
Abstract
Total hip arthroplasty (THA) has been described as the operation of the century. Despite significant advancement in the field of technology, hip instability remains second most common cause of revision hip surgery after infection. There is garning interest to identify role of hip-spine relationship in order to identify high-risk patients for instability after THA. Acetabular component position varies according to spinal alignment and mobility in order to decrease risk of impingement and instability. Preoperative work up includes standing pelvis anteroposterior radiograph and lateral spino-pelvic radiograph in standing and sitting position. The focus of this review is to develop an algorithm to address the spino-pelvic pathology and guide the treatment on the basis of sagittal movement of the spine-pelvis-hip complex and to minimise the rate of dislocation following THA.
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van Duren BH, Royeca JM, Cunningham CM, Lamb JN, Brew CJ, Pandit H. Can the use of an inclinometer improve acetabular cup inclination in total hip arthroplasty? A review of the literature. Hip Int 2021; 31:609-617. [PMID: 32750263 PMCID: PMC8488637 DOI: 10.1177/1120700020946716] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The angle of acetabular (cup) radiographic inclination is an important measurement in total hip arthroplasty (THA) procedures. Abnormal radiographic inclination is associated with dislocation, edge loading and higher failure rates. Consistently achieving a satisfactory radiographic inclination remains a challenge. Inclinometers have been increasingly used over the last decade. This paper reviews the literature to determine whether using an inclinometer improves the accuracy of acetabular cup inclination in THA. METHODS A systematic literature search was performed. The following search terms were used: ('hip' OR 'hip replacement' OR 'hip arthroplasty' OR 'primary hip replacement' OR 'THR' OR 'THA' OR 'Acetabular cup Inclination') AND ('Inclinometer'). Titles and abstracts were screened for relevance. Both radiographic and operative inclination comparisons were included. RESULTS 7 studies met the inclusion criteria. 2 were randomised control trials with level I evidence, and the remaining studies were cohort studies with level III/IV evidence. 5 were clinical and 2 experimental. In total there were 16 cohorts: 7 using an inclinometer, 6 freehand, and 3 using MAG techniques. All studies comparing radiographic inclination and 1 of 2 studies comparing operative inclination showed an improvement in the attainment of the optimal inclination. Similarly, the use of an inclinometer showed a reduction in the number of outliers when compared to MAG and freehand techniques. DISCUSSION This review demonstrates that using an inclinometer improved the surgeon's ability to achieve their intended inclination (both operative and radiographic) and reduced the incidence of positioning outside the safe-zone. However, only 2 of the studies were randomised control trials and these resulted in opposing conclusions. Therefore, further studies looking at the use of inclinometers would prove useful in understanding their true benefit.
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Affiliation(s)
- Bernard H van Duren
- Leeds Orthopaedic and Trauma Sciences, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK,Bernard H van Duren, Leeds Institute of Rheumatic and Musculoskeletal Medicine, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.
| | | | | | - Jonathan N Lamb
- Leeds Orthopaedic and Trauma Sciences, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | | | - Hemant Pandit
- Leeds Orthopaedic and Trauma Sciences, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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Bellity J, Elkaïm M, Hannouche D, Nizard R. Arthroscopic evaluation and treatment of a squeaking hip. A case report. BMC Musculoskelet Disord 2020; 21:805. [PMID: 33272241 PMCID: PMC7713320 DOI: 10.1186/s12891-020-03817-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/22/2020] [Indexed: 11/22/2022] Open
Abstract
Background Squeaking of ceramic-on-ceramic total hip arthroplasty is an unexpected complication which occurs in 1- 30% of patients. Revision surgery is required in 0.2% of the cases, when a ceramic fracture is suspected, or in case of severe malposition of the implants, subluxation, or impingement. Hip arthroscopy may be a useful diagnostic and therapeutic option in squeaking hips. Case presentation A patient presenting with a pain-free squeaking underwent hip arthroscopy to examine the sliding surfaces and the rim of the acetabulum, and to search for signs of impingement. Thorough lavage and debridement of hip synovitis and fibrous tissue was performed. The squeaking noise immediately disappeared after the surgery. The patient was allowed to fully weight bear as tolerated with 2 crutches for 2 weeks. Two years after the arthroscopy, the patient remained symptom-free. Conclusions The potential reasons for hip squeaking in our patient are discussed. Hip arthroscopy may prove useful as a diagnostic and therapeutic option for some patients presenting with a squeaking ceramic-on ceramic hip replacement.
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Affiliation(s)
- Jonathan Bellity
- Department of Orthopaedic Surgery, Lariboisière, Hospital, Paris 7 University, Paris, France
| | - Marc Elkaïm
- Department of Orthopaedic Surgery, Lariboisière, Hospital, Paris 7 University, Paris, France
| | - Didier Hannouche
- Department of Orthopaedic Surgery, Lariboisière, Hospital, Paris 7 University, Paris, France. .,Department of Orthopaedic Surgery, Geneva University Hospitals & Faculty of Medicine, Avenue Gabrielle Perret Gentil 4, 1205, Geneva, Switzerland.
| | - Rémy Nizard
- Department of Orthopaedic Surgery, Lariboisière, Hospital, Paris 7 University, Paris, France
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Modern cup alignment techniques in total hip arthroplasty: A systematic review. Orthop Traumatol Surg Res 2019; 105:907-913. [PMID: 31054840 DOI: 10.1016/j.otsr.2019.03.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 03/05/2019] [Accepted: 03/14/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION A systematic review was conducted to assess the clinical and radiological outcomes of the alternative surgical techniques that consider the dynamic aspect of the acetabular orientation when aligning a cup (pelvic tilt-, lumbo-pelvic kinematics-, and spine-hip relationship-adjusted cup alignment techniques). METHOD Eight eligible articles reported the outcomes of total hip arthroplasty (THA) performed with alternative techniques. Clinical and radiological data were extracted. One study had a control group of patients who underwent conventional THAs (level III) while the seven other studies were level IV. Computer navigation system (CAS), Optimized Positioning System (OPS™), and manual instrumentation were used to align components in four, two, and two studies, respectively. A meta-analysis was not carried out because there was a lack of homogeneity between included articles regarding the method to position the cup and the nature of the reported data. RESULTS THA performed with alternative techniques had an early dislocation rate ranging from 0 to 1.9%, no unexpected catastrophic failure, and acceptable radiographic cup orientations. One study compared kinematically and mechanically aligned THAs and found no dislocation in either groups, similar patient reported outcome measures (43 Oxford-12 Score for both groups), and similar proportions of cup in the Lewinnek zone (respectively 65% and 70%). DISCUSSION/CONCLUSION Alternative methods accounting for the functional acetabular orientation seem to be clinically safe and effective in the early-term, and generate acceptable cup orientation on radiographs. Their values compare to those of more conventional techniques for cup implantation remain to be determined. We developed a classification of the multiple methods for aligning an acetabular component. LEVEL OF EVIDENCE IV, systematic review of level III and IV studies.
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Eftekhary N, Shimmin A, Lazennec JY, Buckland A, Schwarzkopf R, Dorr LD, Mayman D, Padgett D, Vigdorchik J. A systematic approach to the hip-spine relationship and its applications to total hip arthroplasty. Bone Joint J 2019; 101-B:808-816. [DOI: 10.1302/0301-620x.101b7.bjj-2018-1188.r1] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There remains confusion in the literature with regard to the spinopelvic relationship, and its contribution to ideal acetabular component position. Critical assessment of the literature has been limited by use of conflicting terminology and definitions of new concepts that further confuse the topic. In 2017, the concept of a Hip-Spine Workgroup was created with the first meeting held at the American Academy of Orthopedic Surgeons Annual Meeting in 2018. The goal of this workgroup was to first help standardize terminology across the literature so that as a topic, multiple groups could produce literature that is immediately understandable and applicable. This consensus review from the Hip-Spine Workgroup aims to simplify the spinopelvic relationship, offer hip surgeons a concise summary of available literature, and select common terminology approved by both hip surgeons and spine surgeons for future research. Cite this article: Bone Joint J 2019;101-B:808–816.
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Affiliation(s)
- N. Eftekhary
- Division of Adult Reconstructive Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York, USA
| | - A. Shimmin
- Melbourne Orthopaedic Group, Windsor, Australia
| | - J. Y. Lazennec
- Pitié-Salpêtrière Hospital, Pierre-and-Marie-Curie University, Paris, France
| | - A. Buckland
- Division of Adult Reconstructive Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York, USA
| | - R. Schwarzkopf
- Division of Adult Reconstructive Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York, USA
| | - L. D. Dorr
- Keck Medical Center of USC, Los Angeles, California, USA
| | - D. Mayman
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York, USA
| | - D. Padgett
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York, USA
| | - J. Vigdorchik
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York, USA
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