Acetabular Cup Anteversion and Inclination in Hip Range of Motion to Impingement

McCarthy, Thomas F.; Alipit, Vincent; Nevelos, Jim; Elmallah, Randa K.; Mont, Michael A.

doi:10.1016/j.arth.2016.01.067

Cited by 65 publications

(46 citation statements)

References 10 publications

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“…This may partially explain previous clinical studies that identified large cup inclination angle and low cup anteversion as causes of increased polyethylene wear and concur with the finding of increased serum metal ion levels under high cup inclination angles in metal‐on‐metal THA . Reduced wear should be added to the equation when considering the optimal component orientation, together with other objectives such as improved stability, avoidance of impingement, and optimized RoM . In addition, several different factors were associated with the sliding distance and CS ratio for male and female patients, as well as for unilaterally and bilaterally operated patients.…”

Section: Discussionsupporting

confidence: 75%

In vivo sliding distance on the metal‐on‐polyethylene total hip arthroplasty articulation using patient‐specific gait analysis

Peng

Arauz

et al. 2018

Journal Orthopaedic Research

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Metal-on-polyethylene (MoP) is the most commonly used bearing surface in primary total hip arthroplasty (THA). Polyethylene wear debris remains a major concern. Studies investigating the wear performance based on patient-specific in vivo kinematics and component orientation remains largely lacking. The primary goal of this study was to identify patterns of the distribution of sliding distance and cross-shear ratio among THA patients. A validated approach combining dual fluoroscopic imaging system and computed-tomography was utilized to quantify in vivo gait kinematics and component orientations in 48 total hips. The distribution of accumulated sliding distance and cross-shear ratio over the polyethylene bearing surface was calculated and analyzed using principal component analysis (PCA). Strong patient-specific variation in sliding distance and cross-shear ratio was observed. PCA detected two principal components (PCs) of the sliding distance that together contribute to 94.8% of the total variation. PCA detected four PCs that together contribute to 86% of the total variation of the cross-shear ratio. Regression analysis identified a positive association between cross-shear magnitude and axial and frontal range of motion (RoM). Increased cup inclination, stem anteversion, and reduced cup anteversion may lead to superiorly distributed high cross-shear region, potentially accelerating wear. Our study investigated, in vivo sliding distance and cross-shear pattern using a comprehensive patient-specific dataset and detected several wear indicators under in vivo conditions. These findings provided useful reference values that may help to assess wear in MoP THA patients. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

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Section: Discussionsupporting

confidence: 75%

In vivo sliding distance on the metal‐on‐polyethylene total hip arthroplasty articulation using patient‐specific gait analysis

Peng

Arauz

et al. 2018

Journal Orthopaedic Research

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“…The sensibility of results towards the specific geometry gives evidence of the necessity of a patient-specific pre-operative planning, also considering the high variability of anatomic features among different races, genres and ages. 12,26,27 This methodology can be extended to the analysis of other parameters such as the femoral anteversion: various authors demonstrated that the external rotation increases as femoral anteversion decreases. 22,28 Another important parameter is certainly the acetabular cup depth: in particular the mode of impingement is likely to change from bone impingement to prosthetic impingement as the acetabular cup moves deeper.…”

Section: Discussionmentioning

confidence: 99%

A multibody model for the optimization of hip arthroplasty in relation to range of movement

Zanetti¹,

Bignardi²,

Terzini³

et al. 2018

AMJ

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BackgroundThe dislocation of the prosthesized hip is a relevant postoperative complication; this adverse outcome is dependent on the specific patient anatomy and on the artificial joint design. The geometry of the reconstructed hip is one of the key factors and it is usually designed at the time of the preoperative planning when the stem model and size, the head diameter and its offset, and the acetabular cup orientation are selected. AimsIn this work, the authors have developed a numerical model to support the pre-operative planning, allowing assessing the hip range of motion, once the geometry of the implant has been defined. MethodsA multi-body model of a prosthesized hip has been developed, and a dislocating movement has been applied; the software is able to assess the entity of displacements and of applied forces which can produce hip dislocation. ResultsAs a proof of concept, multiple combinations of geometric factors have been examined that are the head diameter, the acetabular cup anteversion and its inclination, reaching a total number of 675 configurations. This software is able to analyse and compare all configurations in few minutes. ConclusionThe developed numerical model can be a support to quickly compare a great number of solutions from the point of view of hip stability, reaching a comprehensive view of all possibilities, and giving a contribute to the final aim that is surgery optimization, in relation to each specific patient. What this study adds: What is known about this subject?Hip dislocation is a relevant complication in hip arthroplasty; this adverse outcome is dependent on the specific patient anatomy and on the artificial joint design. What new information is offered in this study?This study introduced a methodology, based on multibody model, which allows optimising the choice of prosthetic components and their positioning in relation to dislocation risk. What are the implications for research, policy, or practice?The pre-operative planning of hip arthroplasty can take benefit from numerical methods able to foresee the final hip range of motion.

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“…Correct implant positioning is important for good longterm results in total hip arthroplasty (THA). Inadequate orientation of the acetabular component is associated with postoperative impingement [1], dislocation [2], accelerated polyethylene wear [3], liner damage, and restricted range of motion [4]. Surgeons use intraoperative navigation systems to improve the accuracy of implant orientation [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

An accelerometer-based navigation system provides acetabular cup orientation accuracy comparable to that of computed tomography-based navigation during total hip arthroplasty in the supine position

et al. 2020

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Background: Inadequate acetabular component orientation is associated with postoperative impingement, dislocation, and accelerated polyethylene wear. Computed tomography (CT)-based navigation systems provide accuracy for total hip arthroplasty (THA) but are not available in all facilities. Accelerometer-based navigation systems are inexpensive, but their accuracy remains undetermined. This study compares the accuracy of cup orientation in THA using CT-based and accelerometer-based navigation systems. Methods: This retrospective study included 35 consecutive patients (11 males, 24 females; mean age, 65 years) who underwent primary cementless THA via an anterolateral approach in the supine position. Both CT-based and accelerometer-based navigation systems were used simultaneously. The accuracy of cup orientation was compared between the two systems using postoperative CT. Results: The accuracy of cup inclination was 2.7°± 2.0°in the CT-based group and 3.3°± 2.4°in the accelerometer-based group. The accuracy of cup anteversion was 2.8°± 2.6°in the CT-based group and 3.4°± 2.2°in the accelerometer-based group. No significant difference was observed in cup inclination (p = 0.29) or cup anteversion (p = 0.34) between CT-based and accelerometer-based navigation. Conclusions: The accuracy of cup positioning did not differ significantly between CT-based and accelerometer-based navigation systems.

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Acetabular Cup Anteversion and Inclination in Hip Range of Motion to Impingement

Cited by 65 publications

References 10 publications

In vivo sliding distance on the metal‐on‐polyethylene total hip arthroplasty articulation using patient‐specific gait analysis

In vivo sliding distance on the metal‐on‐polyethylene total hip arthroplasty articulation using patient‐specific gait analysis

A multibody model for the optimization of hip arthroplasty in relation to range of movement

An accelerometer-based navigation system provides acetabular cup orientation accuracy comparable to that of computed tomography-based navigation during total hip arthroplasty in the supine position

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