Accuracy of Acetabular Component Position in Hip Arthroplasty

Abstract

Background: Acetabular component malposition is linked to higher bearing surface wear and component instability.

Accuracy of the modified Hardinge approach in acetabular positioning

“…A direct comparison with the study performed by Barrack and colleauges was not possible, as they did not perform any of their surgeries using the modified Hardinge approach. 26 Callanan and colleagues 25 obtained an accuracy of 32% using the direct lateral approach with a slightly narrower reference range consisting of 30°-45° of inclination and 5°-25° of anteversion. 25 Only low-volume surgeons used the direct lateral approach in their study, 25 potentially explaining the greater accuracy seen in our study, in which the surgeries were being performed only by high-volume surgeons.…”

“…There is no consensus in the literature to suggest the ideal position of the acetabular component. Barrack and colleagues 26 used the wider ranges of 30°-55° and 5°-35° as their reference ranges for inclination angle and anteversion, respectively. A direct comparison with the study performed by Barrack and colleauges was not possible, as they did not perform any of their surgeries using the modified Hardinge approach.…”

“…They identified a 68% incidence of cup malpositioning with the use of the direct lateral approach compared with 42.7% when using the posterolateral approach. Barrack and colleagues 26 reported only 21% of the cups positioned outside their defined range using the anterolateral approach. Both studies, however, used different acceptable ranges for the cup position, with an emphasis on the posterolateral approach as the most popular surgical approach at their centres.…”

Patient Specific Component Alignment in Total Hip Arthroplasty

“…Fortunately, the procedure is relatively forgiving of component malalignment, and this has concealed the poor levels of precision achievable without assistive technologies [2][3][4][16][17][18][19][20][21]. Despite the generally high rates of patient satisfaction, failures still occur.…”

“…The limited precision with which a defined target alignment can be achieved intraoperatively, without assistive technologies, has been widely published [2][3][4]. Computer assisted surgery, and more recently robotics, were introduced to improve precision, but with slow uptake from the orthopaedic community.…”