Abstract
BackgroundThe impact of surgeon handedness on acetabular cup orientation in total hip arthroplasty (THA) is not well studied. The aim of our study is to investigate the difference of cup orientation in bilateral THA performed by right-handed surgeons using posterolateral approach and which cup could be fitter to Lewinneck’s safe zone.MethodsThe study consisted of 498 patients that underwent bilateral THA by three right-handed surgeons in our hospital. Postoperative acetabular cup anteversion and abduction on an anteroposterior pelvic radiograph were measured by Orthoview software (Orthoview LLC, Jacksonville, Florida). Furthermore, the percentage of cup placement within the safe zone was compared.ResultsThe mean anteversion was 25.28 (25.28° ± 7.16°) in left THA and 22.01 (22.01° ± 6.35°) in right THA (p < 0.001). The mean abduction was 37.50 (37.50° ± 6.76°) in left THA and 38.59 (38.59° ± 6.84°) in right THA (p = 0.011). In the left side, the cup was positioned in Lewinnek’s safe zone in 52% for anteversion, 87% for abduction, and 46% for both anteversion and abduction. But the cup placement within Lewinnek’s safe zone was 71, 88, and 62% in the right side, respectively. There were significant differences in the percentage of acetabular cup placement within the safe zone for anteversion (p < 0.001) and for both anteversion and inclination (p < 0.001). Dislocation occurred in 7.0% (35/498) of cases in left THA and 3.2% (16/498) in right THA. The percentages of patients experiencing dislocation were significantly different between the two sides (p = 0.006).ConclusionsThis current study demonstrated that surgeon handedness is likely to be a contributing factor that affects cup inclination and anteversion in bilateral THA and that the placement of cup performed by dominant hands of surgeons is more accurate than that performed by non-dominant sides.
Highlights
The impact of surgeon handedness on acetabular cup orientation in total hip arthroplasty (THA) is not well studied
Acetabular cup orientation including anteversion and inclination is a crucial factor for the functional outcome after total hip arthroplasty (THA) [1, 2]
These THAs were performed by three experienced orthopedic surgeons who had performed more than 300 THAs annually
Summary
The impact of surgeon handedness on acetabular cup orientation in total hip arthroplasty (THA) is not well studied. Acetabular cup orientation including anteversion and inclination is a crucial factor for the functional outcome after total hip arthroplasty (THA) [1, 2]. Orthopedic surgeons operate on both sides of patients’ hips in many musculoskeletal disorders that affect hips such as osteonecrosis, osteoarthritis, dysplasia, ankylosing spondylitis, and so on. Their operating position changes with different sides of patients when THA is being performed, when patients are in lateral decubitus position with the posterolateral approach.
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