Abstract
ObjectiveTo evaluate the impact of spinopelvic parameters and hip contracture on change in the pelvic tilt (PT) after Total hip arthroplasty (THA).MethodsOne hundred patients (15 male and 85 female) who underwent THA were included in this prospective study. Radiographic data were obtained preoperatively and 1 year after THA. Radiographic parameters included sagittal anterior pelvic plane (APP), sagittal vertical axis (SVA), sacral slope (SS), pelvic inclination (PI), and lumbar lordosis angle (LL). The APP was defined as the angle between the anterior pelvic plane and the vertical plane. A positive value indicates pelvic retroversion. Postoperative changes in PT were divided into three groups: the PA group (pelvic anteversion, ΔAPP < −5°), the PR group (pelvic retroversion, ΔAPP > 5°), and the PT group (minimal change, ΔAPP ≤ ± 5°). The Kruskal–Wallis test and the Steel–Dwass test were used to compare the preoperative and postoperative spinopelvic parameters among the three groups. The Spearman's rank correlation coefficient was used to evaluate the correlation between ΔAPP and spinopelvic parameters.ResultsMinimal change in pelvic tilt was observed in 59% of patients, while pelvic anteversion was observed in 16% of patients and pelvic retroversion was observed in 25% of patients. There were no significant changes in the spinopelvic parameters, including TK, LL, SVA, LL, SS, and APP after THA. The Femoral angle (FA) was significantly decreased after THA (P < 0.001). Preoperative APP was significantly more retroverted in the PA group than the PR group, and the PT group (6.8 ± 12.2, 0.2 ± 9.9, −8.3 ± 8.3, P < 0.001). Preoperative SS, PI‐LL, and PI were significantly smaller in the PA group than the PT group and the PR group. A significant negative correlation was identified between preoperative APP and ΔAPP (r = −0.418, P < 0.001).ConclusionApproximately 60% of the patients did not have any marked change in PT after THA. Preoperative APP was the only predictive factor associated with marked anterior or posterior change in PT.
Highlights
The accurate positioning of the acetabular cup in total hip arthroplasty (THA) is important to optimize functional outcomes and to reduce the incidence of complications, including dislocation, impingement, and polyethylene wear[1,2,3,4]
The authors of the current study have previously reported on the accuracy of acetabular cup orientation using a CT-free navigation system[5,6]
Cup orientation is affected by the pelvic tilt (PT), and several studies have demonstrated the postural change in PT between sitting, supine and standing position[7,8,9]
Summary
The accurate positioning of the acetabular cup in total hip arthroplasty (THA) is important to optimize functional outcomes and to reduce the incidence of complications, including dislocation, impingement, and polyethylene wear[1,2,3,4]. The authors of the current study have previously reported on the accuracy of acetabular cup orientation using a CT-free navigation system[5,6]. Cup orientation is affected by the pelvic tilt (PT), and several studies have demonstrated the postural change in PT between sitting, supine and standing position[7,8,9]. Postoperative change in PT is important for accurate preoperative planning of acetabular cup angles. The effect of PT on acetabular cup anteversion has been reported to be an approximately 0.7 increase in anteversion for each degree of posterior PT10
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
