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Nguyen DH, Nguyen TT, Le KT, Pham ST, Dang VH, Le XH, Le MDT, Vo HL, Tran TD. Morphological Characteristics of the Vietnamese Adult Human Acetabulum Using Multiplanar Reconstruction Computed Tomography in Total Hip Replacement Surgery. Orthop Rev (Pavia) 2024; 16:94242. [PMID: 38469578 PMCID: PMC10927311 DOI: 10.52965/001c.94242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 02/05/2024] [Indexed: 03/13/2024] Open
Abstract
Background The anatomical parameters of the acetabulum vary among races and geographical regions. Multislice Computed Tomography (CT) has proven to be a practical approach to assess morphological parameters of the acetabulum. The purpose of this study was to explore morphological characteristics of the acetabulum measured by CT scans in Vietnamese adults. Methods Thirty-five consecutive patients aged 18 years and older received indications and eligibility for total hip replacement surgery. Sixty-three acetabulum were examined with multislice computed tomographic system (CT) with multiplanar reconstruction (MPR). Measured morphometric parameters of acetabulum included acetabular inclination angle (AIA), acetabular anteversion angle (AAA), acetabular angle of sharp (AAS), sagittal acetabular angle (SAA), acetabular horizontal offset (AHO), transverse acetabular ligament anteversion (TALA), transverse acetabular ligament inclination (TALI), acetabular depth (ADe), acetabular depth ratio (ADr) and acetabular diameter (ADi). Results The mean values of acetabular diameter, femoral head diameter, AIA, AAA, AAS, SAA, TALA, TALI, AHO, ADe, ADr were 50.22±3.56 mm, 43.54±3.68 mm, 40.27±5.09 mm, 13.30±5.54 mm, 39.46±5.41 mm, 26.38±9.01 mm, 9.49±3.92 mm, 47.70±6.73 mm, 3.06±0.37 mm, 18.62±2.95 mm and 309.60±41.87 mm. Conclusion Our initial data has showed morphological characteristics of the acetabulum in Vietnamese adults, different from the populations from other parts of world. Also, significant correlation between the orientation of the acetabulum and the transverse acetabular ligament was documented.
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Affiliation(s)
- Dinh-Hieu Nguyen
- Department of Orthopaedic Surgery and Sports Medicine E Hospital
- Hanoi Medical University
| | - Trung-Tuyen Nguyen
- Department of Orthopaedic Surgery and Sports Medicine E Hospital
- University of Medicine and Pharmacy, Vietnam National University
| | - Khanh-Trinh Le
- Department of Orthopaedic Surgery and Sports Medicine E Hospital
| | - Son-Tung Pham
- Department of Orthopaedic Surgery and Sports Medicine E Hospital
| | - Van-Hieu Dang
- Department of Orthopaedic Surgery and Sports Medicine E Hospital
| | - Xuan-Hoang Le
- Department of Orthopaedic Surgery and Sports Medicine E Hospital
| | - Minh-Duc T Le
- Department of Orthopaedic Surgery and Sports Medicine E Hospital
| | - Hoang-Long Vo
- Department of Science, Technology, Communication & International Cooperation E Hospital
| | - Trung-Dung Tran
- Department of Orthopaedic Surgery, College of Health Science VinUniversity
- Orthopaedic and Sports Medicine Center Vinmec International Hospital
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Haluzynskyi OA, Chornyi VS, Burburska SV, Kozik YV. USE OF COMPUTER NAVIGATION IN TOTAL HIP ARTHROPLASTY (LITERATURE REVIEW). WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1765-1770. [PMID: 35962695 DOI: 10.36740/wlek202207128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim: Analyze the accuracy and ease of use of various computer navigations in total hip arthroplasty. PATIENTS AND METHODS Materials and methods: Data from about 50 literature sources for the last two decades have been analysed. CONCLUSION Conclusions: Analyzing the accuracy and ease of use of various computer navigations in total hip arthroplasty, we offer two the most promising for further study and improvement systems: a semi-active navigation system and augmented reality system in total hip arthroplasty.
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Affiliation(s)
| | | | - Svitlana V Burburska
- SI "INSTITUTE OF TRAUMATOLOGY AND ORTHOPEDICS OF NAMS OF UKRAINE", KYIV, UKRAINE
| | - Yevhenii V Kozik
- SI "INSTITUTE OF TRAUMATOLOGY AND ORTHOPEDICS OF NAMS OF UKRAINE", KYIV, UKRAINE
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Burapachaisri A, Elbuluk A, Abotsi E, Pierrepont J, Jerabek SA, Buckland AJ, Vigdorchik JM. Lewinnek Safe Zone References are Frequently Misquoted. Arthroplast Today 2020; 6:945-953. [PMID: 33299915 PMCID: PMC7701843 DOI: 10.1016/j.artd.2020.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/13/2020] [Accepted: 09/27/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Optimal acetabular component orientation in total hip arthroplasty (THA) is a necessity in achieving a stable implant. Although there has been considerable debate in the literature concerning the safe zone, to date, there has not been any review to determine if these references are consistent with the definition applied by Lewinnek et al. in 1978. Therefore, this article aims to examine the available literature in the PubMed database to determine how often a correct reference to the safe zone as defined by Lewinnek was applied to discussions regarding THA. METHODS A search for literature in the PubMed database was performed for articles from 1978 to 2019. Search criteria included terms 'Lewinnek,' 'safe zone,' and 'total hip arthroplasty.' Exclusions included abstract-only articles, non-English articles, articles unrelated to THA, and those lacking full content. RESULTS A review of literature yielded 147 articles for inclusion. Overall, only 11% (17) cited the Lewinnek article correctly. Forty-five percent (66) of articles referenced measurements in the supine position, 18% (26) referenced other positions, and 37% (55) did not specify. Nineteen percent (28) reported measurements of the acetabular cup orthogonal to the anterior pelvic plane, while 73% (108) did not, and 7% (11) did not specify. Twenty-three percent (34) measured from computed tomography scans instead of other methods. CONCLUSIONS In the discussion of the safe zone regarding THA, only 11% of articles listed are consistent with the definition established by Lewinnek. This warrants further investigation into a consistent application of the term and its implications for THA implant stability and dislocation rates.
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Affiliation(s)
- Aonnicha Burapachaisri
- Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA
| | - Ameer Elbuluk
- Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA
| | - Edem Abotsi
- Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA
| | - Jim Pierrepont
- Chief Innovation Officer, Corin Group, New South Wales, Australia
| | - Seth A. Jerabek
- Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA
| | - Aaron J. Buckland
- Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA
| | - Jonathan M. Vigdorchik
- Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA
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ALDI (Anterior Lateral Decubitus Intermuscular) approach to the hip: Comprehensive description of the surgical technique with operative video. Orthop Traumatol Surg Res 2019; 105:923-930. [PMID: 31178409 DOI: 10.1016/j.otsr.2019.02.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/19/2019] [Accepted: 02/26/2019] [Indexed: 02/06/2023]
Abstract
The direct anterior approach to the hip is judged to be difficult and even after many solutions, such as special operating tables, have been proposed to perform it, in some reports the complication rate remains high. The complications reported are nerve lesions, dislocation, muscles damages, intraoperative fractures. We describe a modification of the anterior approach, undertaken keeping the patient in lateral decubitus, in order to gain a better range of leg movement and a significant reduction of the force applied to the retractors, the technique was named ALDI (anterior lateral decubitus intermuscular) approach. The surgeon starts behind the patient as in all the other traditional approaches, to maintain unchanged the acetabular view and the dexterity in cup implantation. For the femoral preparation, he moves in front of the patient to have a better visualization. In a series of 150 patients, with a mean operative time of 51.38minutes (range, 40-112), we had no intraoperative fractures, one (0.6%) lateral femoral cutaneous nerve temporary neurapraxia, one (0.8%) posttraumatic dislocation four years after the operation and, no revisions for aseptic loosening or infection. At the 5 years follow-up, the mean Oxford Hip score was 45.2 (range, 38-48; SD 2.6), the mean Harris Hip Score was 96,7 (range, 76-100; SD 2.8), and the mean UCLA score was 7 (range, 5-10; SD 1.4). The possibility to always obtain the optimal position of the surgical window with reduced tension on the muscles, and the unchanged initial surgeon position, could make the ALDI approach the ideal technique for the surgeons that decide to perform an anterior approach.
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Li Y, Liu Y, Zhou Q, Chen W, Li J, Yu L, Xu H, Xie D. Magnetic resonance imaging evaluation of acetabular orientation in normal Chinese children. Medicine (Baltimore) 2016; 95:e4878. [PMID: 27631258 PMCID: PMC5402601 DOI: 10.1097/md.0000000000004878] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
There are no data regarding the acetabular orientation on magnetic resonance imaging (MRI); this study investigates the changes of acetabular orientation with age in normal Chinese children.We retrospectively analyzed the medical records of children who underwent hip MRI examination at our hospital from January 2009 to December 2015. A total of 180 patients with normal MRI reading of the hip joints were included and were divided into 14 groups according to age: from 6 months of age and then for each year from 1 to 16 years. The bony and cartilage acetabular anteversion angle (AAA), acetabular inclination angle (AIA), and acetabular index (AI) were measured. Total bony and cartilage femoral head coverage angles were measured on axial section total femoral head coverage angle (a-TCA) and coronal section total femoral head coverage angle (c-TCA).The mean bony AAA and AIA were 12.2 ± 2.5° and 50.9 ± 2.5°, respectively; both of them stayed constant from the age of 6 months to 16 years. Similar results were found in cartilage AAA (12.1 ± 2.5°) and AIA (41.2 ± 3.0°). There was no difference between bony and cartilage AAA, but bony AIA was significantly larger than cartilage AIA. Bony AI was 24.1 ± 2.4° at the age of 6 months, decreasing to 12.5 ± 2.3° by 12 to 13 years of age; cartilage AI (5.9 ± 1.7°) maintained a steady value with age. The mean bony a-TCA and c-TCA at 6 months were 117.0 ± 5.8° and 127.5 ± 5.1°, increasing to 144.5 ± 4.6° and 140.7 ± 2.5° at the age of 16 years. However, the cartilage a-TCA (145.2 ± 7.2°) and c-TCA (154.1 ± 5.7°) did not change significantly with age.Both bony and cartilage AAA and AIA remain constant up to the age of 16 years in normal Chinese pediatric population. Although the cartilage coverage of femoral head by the acetabulum remains unchanged with age, the bony coverage of femoral head increases.
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Affiliation(s)
- YiQiang Li
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University
| | - YuanZhong Liu
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University
| | - QingHe Zhou
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University
| | - WeiDong Chen
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University
| | - JingChun Li
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University
| | - LingJia Yu
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University
| | - HongWen Xu
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University
- Correspondence: HongWen Xu, Department of Orthopedics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9th JinSui Road, Guangzhou 510623, China (e-mail: ); DengHui Xie, Department of Orthopedics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9th JinSui Road, Guangzhou 510623, China; Southern Medical University, Guangzhou 510515, China (e-mail: )
| | - DengHui Xie
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University
- Southern Medical University, Guangzhou, China
- Correspondence: HongWen Xu, Department of Orthopedics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9th JinSui Road, Guangzhou 510623, China (e-mail: ); DengHui Xie, Department of Orthopedics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9th JinSui Road, Guangzhou 510623, China; Southern Medical University, Guangzhou 510515, China (e-mail: )
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Yoon BH, Ha YC, Lee YK, Jo WL, Lee KM, Koo KH. Is transverse acetabular ligament a reliable guide for aligning cup anteversion in total hip arthroplasty?: A measurement by CT arthrography in 90 hips. J Orthop Sci 2016; 21:199-204. [PMID: 26714668 DOI: 10.1016/j.jos.2015.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 10/05/2015] [Accepted: 11/19/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Transverse acetabular ligament (TAL) has been used as a landmark for aligning cup anteversion. The use of TAL as a guide is based on the assumption that TAL version is distributed within the safe zone of acetabular cup. However, there was rarely reported to compare anteversion between TAL and acetabulum using direct measurement methods. The purpose of this study was to measure the anteversion of TAL in computed tomography arthrography (CTA) and compare it with Lewinnek's safe zone and anteversion of bony acetabulum. METHODS 81 patients (90 hips) were selected among 204 patients (228 hips) who received CTA for hip pathology evaluation between March 2010 and June 2013. The anteversion of TAL measured at the lowest level of the acetabular notch and the anteversion of the acetabulum was measured at the level of femoral head center. RESULTS The mean TAL anteversion was 11.8° (SD 4.5, range 0-22.2). In eight hips (8.8%), TAL anteversion was outside the safe zone (15° ± 10°) as defined by Lewinnek. The mean acetabular anteversion was 13.3° ± 4.4° (range -1.0° to 22.6°). There was a strong correlation between TAL anteversion and acetabular anteversion (Pearson's correlation coefficient; 0.908, p < 0.001). CONCLUSIONS TAL anteversion has a large individual variation, and considerable portion of hips have TAL anteversion outside the safety zone of cup anteversion. TAL anteversion is influenced by acetabular anteversion. In hips with retroverted or pauci-anteverted acetabulum, TAL should be used cautiously because there is a risk of cup malposition.
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Affiliation(s)
- Byung-Ho Yoon
- Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, South Korea.
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, South Korea.
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
| | - Woo-Lam Jo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
| | - Kyoung-Min Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
| | - Kyung-Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
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Meermans G, Van Doorn WJ, Koenraadt K, Kats J. The use of the transverse acetabular ligament for determining the orientation of the components in total hip replacement. Bone Joint J 2014; 96-B:312-8. [DOI: 10.1302/0301-620x.96b3.32989] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The orientation of the acetabular component can influence both the short- and long-term outcomes of total hip replacement (THR). We performed a prospective, randomised, controlled trial of two groups, comprising of 40 patients each, in order to compare freehand introduction of the component with introduction using the transverse acetabular ligament (TAL) as a reference for anteversion. Anteversion and inclination were measured on pelvic radiographs. With respect to anteversion, in the freehand group 22.5% of the components were outside the safe zone versus 0% in the transverse acetabular ligament group (p = 0.002). The mean angle of anteversion in the freehand group was 21° (2° to 35°) which was significantly higher compared with 17° (2° to 25°) in the TAL group (p = 0.004). There was a significant difference comparing the variations of both groups (p = 0.008). With respect to inclination, in the freehand group 37.5% of the components were outside the safe zone versus 20% in the TAL group (p = 0.14). There was no significant difference regarding the accuracy or variation of the angle of inclination when comparing the two groups. The transverse acetabular ligament may be used to obtain the appropriate anteversion when introducing the acetabular component during THR, but not acetabular component inclination. Cite this article: Bone Joint J 2014;96-B:312–18.
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Affiliation(s)
- G. Meermans
- Lievensberg Hospital, Boerhaaveplein
1, 4624 VT Bergen Op Zoom, the
Netherlands
| | | | - K. Koenraadt
- Lievensberg Hospital, Bergen
Op Zoom, the Netherlands
| | - J. Kats
- Lievensberg Hospital, Bergen
Op Zoom, the Netherlands
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