Abstract
BackgroundIn total hip arthroplasty (THA), tilting of the pelvis alters the cup placement angles. Thus, the cup angles need to be planned with consideration of the effects of pelvic tilt. In the present study, we evaluated the efficacy of preoperative planning for implant placement with consideration of pelvic tilt in THA, and the accuracy of a CT-based computer navigation for implant positioning.MethodsWe examined 75 hips of 75 patients who underwent THA and were followed-up for one year postoperatively. The patients were divided into three groups (anterior, intermediate, posterior tilt) according to their preoperative pelvic tilt. Preoperative planning for implant placement was made with consideration of pelvic tilt and a CT-based navigation was used to execute the preoperative planning. Cup inclination, cup anteversion, and combined anteversion (CA) in supine and standing positions were examined 1 year after THA. The accuracy of the computer navigation was also examined.ResultsMean CA was 35.0 ± 5.8° in supine position and 39.3 ± 5.7° in standing position. CA did not differ among the three subgroups (anterior, intermediate, posterior tilt) in either supine or standing position, indicating implant placements to be equally effective. The desired CA (37.3°) was midway between those in supine and standing positions for each subgroup. Respective mean absolute errors between preoperative planning and postoperative CT measurement was 5.3 ± 5.2° for CA.ConclusionWe obtained favorable THA results with preoperative planning with consideration of pelvic tilt by demonstrating supine and standing CA to be unaffected by preoperative pelvic tilt one year postoperatively. Mean absolute error of CA between preoperative planning and postoperative measurement was 5° with use of the CT-based navigation.
Highlights
In total hip arthroplasty (THA), tilting of the pelvis alters the cup placement angles
Yoshimine reported the results of a study based on the combined anteversion (CA) theory, in which cup anteversion and stem antetorsion are combined for consideration; this theory was adopted for this study [7]
We evaluated outcomes for postoperative implant placement angles in patients who underwent THA performed according to preoperative plans made with consideration of pelvic tilt
Summary
In total hip arthroplasty (THA), tilting of the pelvis alters the cup placement angles. In total hip arthroplasty (THA), the implant placement angle is associated with postoperative complications, such as wear of the articular surface and dislocation It is an important factor for achieving a favorable postoperative range of motion [1,2,3]. Yoshimine reported the results of a study based on the combined anteversion (CA) theory, in which cup anteversion and stem antetorsion are combined for consideration; this theory was adopted for this study [7]. These optimum cup placement angles are achieved in certain leg positions, tilting of the pelvis, to which the cup is fixed, alters the cup placement angles in tandem. There are neither reports presenting specific preoperative planning methods, nor studies evaluating the usefulness of preoperative planning with consideration of pelvic tilt
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