Body mass index and acetabular component position in total hip arthroplasty

McBride, Andrew; Flynn, Jennifer N.; Miller, Gavin; Barnes, Matthew J.; Mackie, Scott

doi:10.1111/j.1445-2197.2012.06176.x

Cited by 20 publications

(9 citation statements)

References 9 publications

(21 reference statements)

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“…To our knowledge, there are no studies till date which assess a direct relationship of BMI with orientation of native acetabular rim and TAL. However, the association of high BMI with variation in cup placement during THA has been attributed to issues pertaining to stable patient positioning, intraoperative challenges such as excessive traction/retraction and poor visualisation of landmarks [37,38]. Pirard et al [39] in a retrospective analysis found no significant relationship between BMI and version of the acetabular cup.…”

Section: Discussionmentioning

confidence: 99%

Orientation of Transverse Acetabular Ligament With Reference to Anterior Pelvic Plane

et al. 2021

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Background: Transverse acetabular ligament (TAL) is a 3-dimensional structure which cannot be defined by a single plane. Therefore, we aimed at describing the orientation of different parts of TAL with respect to anterior pelvic plane (APP) and correlate it with gender, body mass index (BMI), and Lewinnek's safe zone. Methods: A total of 109 consecutive patients undergoing imageless navigated THA were prospectively studied. Computer navigation was used as the measurement tool. APP was registered for navigation. After excision of osteophytes, a trial component matching the size of unreamed acetabular cavity was aligned with acetabular rim, outer and inner margins, and middle of TAL to record cup orientation with computer tracker. Results: Ninety-nine patients (41 males and 58 females, mean BMI of 28.8kg/m 2 ) were studied after applying exclusion criteria. Mean acetabular inclination was 55.15 , 53.00 , 47.70 , and 42.60 respectively, for acetabular rim, outer, middle, and inner margins of the TAL. Corresponding mean acetabular anteversion was 6.63 , 7.41 , 11.23 and 14.90 respectively. Overall, 17.17%, 28.28%, 47.47% and 71.71% of cup orientation corresponding to acetabular rim, outer, middle, and inner margin of TAL respectively, were within Lewinnek's safe zone. No association was established between BMI and acetabular orientation. Males had overall lesser anteversion than females. Conclusion: We describe orientation of outer, middle, and inner margins of TAL, as reference planes for TAL, in relation to APP. The anteversion differs significantly with gender. A knowledge about these will assist surgeon in component placement during THA, with inner margin of TAL providing the best chance of orientation out of the studied landmarks.

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Section: Discussionmentioning

confidence: 99%

Orientation of Transverse Acetabular Ligament With Reference to Anterior Pelvic Plane

et al. 2021

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“…As previously discussed, incorrect acetabular prosthetic cup positioning is known to be associated with poor clinical outcomes, such as impingement, instability or prosthetic failure [1,4,2,3,5]. It is therefore important to determine an acceptable degree to PR that will not signi cantly bias preoperative planning.…”

Section: Discussionmentioning

confidence: 99%

“…The acetabular prosthesis implantation angle affects muscle strength, gait, limb lengths, impingement, noise generation, loosening, postoperative range of movement (ROM) and is related to dislocation and liner wear [7]. Optimising biomechanical and anatomical reconstruction of the joint is essential to achieve function, longevity and prevention of complications following surgery [1][2][3][4][5][6]. Preoperative templating from a plain anterior-posterior radiograph is the primary method for initial evaluation and cornerstone for prosthesis positioning, however such images are subject to patient pelvic tilt and rotation.…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of Pelvic Malrotation on X-ray based Preoperative Planning for Total Hip Arthroplasty: A Proof-of-concept and Prudent Prediction of Acceptable Rotation

Lourens

Kurmis

Lim

2021

Preprint

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IntroductionPelvic rotation (PR) on preoperative X-ray templating can affect various critical measured acetabular angles and potentially outcomes of successful total hip arthroplasty (THA). Optimising anatomical reconstruction of the joint is essential to achieve function, longevity and prevention of complications following surgery. There is limited literature that standardises the degree of acceptable PR on X-ray or its effects on the fitting of acetabular prostheses. ObjectiveThis study aimed to develop a proof-of-concept that quantifies how PR can affect various acetabular angles used in pre-operative THA templating and to formulate a practicable method of determining if the preoperative PR is acceptable. Materials and MethodsComputerised tomography (CT) models from three control and two THA patients were generated and manipulated in various degrees of PR. CT slices were thickened to simulate X-rays and acetabular angles measured. ResultsThe acetabular anteversion distance (AAD) and lateral opening angle (LOA) demonstrated a linear and quadratic relationship with good correlation (R2=0.923, R2=0.710 respectively, p<0.0001) in relation to PR. Change in area of prosthesis (AOP) demonstrated a good linear correlation (r2=0.774 and r2=0.875, p<0.0001) with PR. Two novel measurements were used to estimate the degree of PR from a pelvic X-ray; the horizontal distance between pubic symphysis and middle of sacrococcygeal joint (PSSC) and the simplified pelvic rotation ratio (SPRR). A strong correlation between PSSC and SPRR with change in PR was observed (R2=0.970, R2=0.953, p<0.001). ConclusionPreliminary results suggests that an SPRR >2.0 correlates to PR>20° with potential to have a clinical impact on preoperative measurements.

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“…PSI THA technology could also carry advantages for treating patients with a high body mass index (BMI) or unique morphologies. A higher BMI correlates with malpositioned acetabular cups in THAs, yet Small et al found no difference in positioning for those patients with high BMI in patient‐specific THAs. This is attributed to the fact that traditional THA operative plans are impacted by soft tissue, patient positioning, and the degree of pathology.…”

Section: Current Applicationsmentioning

confidence: 99%

Patient‐Specific Orthopaedic Implants

Haglin

Eltorai

Gil

et al. 2016

Orthopaedic Surgery

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Patient-specific orthopaedic implants are emerging as a clinically promising treatment option for a growing number of conditions to better match an individual's anatomy. Patient-specific implant (PSI) technology aims to reduce overall procedural costs, minimize surgical time, and maximize patient outcomes by achieving better biomechanical implant fit. With this commercially-available technology, computed tomography or magnetic resonance images can be used in conjunction with specialized computer programs to create preoperative patient-specific surgical plans and to develop custom cutting guides from 3-D reconstructed images of patient anatomy. Surgeons can then place these temporary guides or "jigs" during the procedure, allowing them to better recreate the exact resections of the computer-generated surgical plan. Over the past decade, patient-specific implants have seen increased use in orthopaedics and they have been widely indicated in total knee arthroplasty, total hip arthroplasty, and corrective osteotomies. Patient-specific implants have also been explored for use in total shoulder arthroplasty and spinal surgery. Despite their increasing popularity, significant support for PSI use in orthopaedics has been lacking in the literature and it is currently uncertain whether the theoretical biomechanical advantages of patient-specific orthopaedic implants carry true advantages in surgical outcomes when compared to standard procedures. The purpose of this review was to assess the current status of patient-specific orthopaedic implants, to explore their future direction, and to summarize any comparative published studies that measure definitive surgical characteristics of patient-specific orthopaedic implant use such as patient outcomes, biomechanical implant alignment, surgical cost, patient blood loss, or patient recovery.

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Body mass index and acetabular component position in total hip arthroplasty

Cited by 20 publications

References 9 publications

Orientation of Transverse Acetabular Ligament With Reference to Anterior Pelvic Plane

Orientation of Transverse Acetabular Ligament With Reference to Anterior Pelvic Plane

Clinical Impact of Pelvic Malrotation on X-ray based Preoperative Planning for Total Hip Arthroplasty: A Proof-of-concept and Prudent Prediction of Acceptable Rotation

Patient‐Specific Orthopaedic Implants

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