Cup orientation following posterior approach THA – the effect of different visual aids and pelvic supports
Abstract Introduction This study aims to compare cup inclination achieved (1) Using two orientation guides, whilst using the same 3-point pelvic positioner and (2) Using two types of pelvic positioners, whilst measuring intra-operative cup inclination with an inclinometer. Materials and methods This...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-05820-w |
| _version_ | 1811265171687997440 |
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| author | Moritz M. Innmann Jeroen Verhaegen Christian Merle Paul E. Beaulé Geert Meermans George Grammatopoulos |
| author_facet | Moritz M. Innmann Jeroen Verhaegen Christian Merle Paul E. Beaulé Geert Meermans George Grammatopoulos |
| author_sort | Moritz M. Innmann |
| collection | DOAJ |
| description | Abstract Introduction This study aims to compare cup inclination achieved (1) Using two orientation guides, whilst using the same 3-point pelvic positioner and (2) Using two types of pelvic positioners, whilst measuring intra-operative cup inclination with an inclinometer. Materials and methods This is a prospective, diagnostic cohort study of a consecutive series of 150 THAs performed through a posterior approach. Two types of 3-point pelvic positioners were used (Stulberg and modified Capello Hip Positioners) and the cup was positioned freehand using one of two orientation guides (mechanical guide or digital inclinometer). Intra-operative inclination was recorded, radiographic cup inclination and anteversion were measured from radiographs. The differences in inclination due to pelvic position (ΔPelvicPosition) and orientation definitions (ΔDefinition) were calculated. Target radiographic inclination and anteversion was 40/20° ± 10°. Results There was no difference in radiographic cup inclination/ (p = 0.63) using a mechanical guide or digital inclinometer. However, differences were seen in ΔPelvicPosition between the positioners ((Stulberg: 0° ± 5 vs. Capello: 3° ± 6); p = 0.011). Intra-operative inclination at implantation was different between positioners and this led to equivalent cases within inclination/anteversion targets (Stulberg:84%, Capello:80%; p = 0.48). Conclusions With the pelvis securely positioned with 3-point supports, optimum cup orientation can be achieved with both alignment guides and inclinometer. Non-optimal cup inclinations were seen when intra-operative inclinations were above 40° and below 32°, or the ΔPelvicPosition was excessive (> 15°; n = 2). We would thus recommend that the intra-operative cup inclination should be centered strictly between 30° and 35° relative to the floor. Small differences exist between different type of pelvic positioners that surgeons need to be aware off and account for. |
| first_indexed | 2024-04-12T20:18:50Z |
| format | Article |
| id | doaj.art-0369dc5959b6445fb609cb59feaab805 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-12T20:18:50Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-0369dc5959b6445fb609cb59feaab8052022-12-22T03:18:03ZengBMCBMC Musculoskeletal Disorders1471-24742022-09-0123111010.1186/s12891-022-05820-wCup orientation following posterior approach THA – the effect of different visual aids and pelvic supportsMoritz M. Innmann0Jeroen Verhaegen1Christian Merle2Paul E. Beaulé3Geert Meermans4George Grammatopoulos5Division of Orthopaedic Surgery, The Ottawa Hospital, Critical Care WingDivision of Orthopaedic Surgery, The Ottawa Hospital, Critical Care WingDepartment of Orthopaedics and Trauma Surgery, University of HeidelbergDivision of Orthopaedic Surgery, The Ottawa Hospital, Critical Care WingDepartment of Orthopaedics, Bravis HospitalDivision of Orthopaedic Surgery, The Ottawa Hospital, Critical Care WingAbstract Introduction This study aims to compare cup inclination achieved (1) Using two orientation guides, whilst using the same 3-point pelvic positioner and (2) Using two types of pelvic positioners, whilst measuring intra-operative cup inclination with an inclinometer. Materials and methods This is a prospective, diagnostic cohort study of a consecutive series of 150 THAs performed through a posterior approach. Two types of 3-point pelvic positioners were used (Stulberg and modified Capello Hip Positioners) and the cup was positioned freehand using one of two orientation guides (mechanical guide or digital inclinometer). Intra-operative inclination was recorded, radiographic cup inclination and anteversion were measured from radiographs. The differences in inclination due to pelvic position (ΔPelvicPosition) and orientation definitions (ΔDefinition) were calculated. Target radiographic inclination and anteversion was 40/20° ± 10°. Results There was no difference in radiographic cup inclination/ (p = 0.63) using a mechanical guide or digital inclinometer. However, differences were seen in ΔPelvicPosition between the positioners ((Stulberg: 0° ± 5 vs. Capello: 3° ± 6); p = 0.011). Intra-operative inclination at implantation was different between positioners and this led to equivalent cases within inclination/anteversion targets (Stulberg:84%, Capello:80%; p = 0.48). Conclusions With the pelvis securely positioned with 3-point supports, optimum cup orientation can be achieved with both alignment guides and inclinometer. Non-optimal cup inclinations were seen when intra-operative inclinations were above 40° and below 32°, or the ΔPelvicPosition was excessive (> 15°; n = 2). We would thus recommend that the intra-operative cup inclination should be centered strictly between 30° and 35° relative to the floor. Small differences exist between different type of pelvic positioners that surgeons need to be aware off and account for.https://doi.org/10.1186/s12891-022-05820-wHipArthroplastyPelvisPositionPosterior approachCup |
| spellingShingle | Moritz M. Innmann Jeroen Verhaegen Christian Merle Paul E. Beaulé Geert Meermans George Grammatopoulos Cup orientation following posterior approach THA – the effect of different visual aids and pelvic supports BMC Musculoskeletal Disorders Hip Arthroplasty Pelvis Position Posterior approach Cup |
| title | Cup orientation following posterior approach THA – the effect of different visual aids and pelvic supports |
| title_full | Cup orientation following posterior approach THA – the effect of different visual aids and pelvic supports |
| title_fullStr | Cup orientation following posterior approach THA – the effect of different visual aids and pelvic supports |
| title_full_unstemmed | Cup orientation following posterior approach THA – the effect of different visual aids and pelvic supports |
| title_short | Cup orientation following posterior approach THA – the effect of different visual aids and pelvic supports |
| title_sort | cup orientation following posterior approach tha the effect of different visual aids and pelvic supports |
| topic | Hip Arthroplasty Pelvis Position Posterior approach Cup |
| url | https://doi.org/10.1186/s12891-022-05820-w |
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