Can pelvic tilting be ignored in total hip arthroplasty?

Shon, Won Yong; Sharma, Vivek; keon, Oh jong; Moon, Jun Gyu

doi:10.1016/j.ijscr.2014.07.015

Cited by 32 publications

(20 citation statements)

References 12 publications

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“…Position of the pelvis is a key in determining the sagittal balance of the spine. It should be remembered that most of the compensatory abilities in imbalance are possible due to a change in the position of the pelvis [14,22,[49][50][51][52][53]. The main parameter of the pelvis is PI (deviation of the pelvis from the vertical axis), due to the fact that it is an unchangeable morphological and individual parameter for each person.…”

Section: Discussionmentioning

confidence: 99%

“…Dynamic parameters are interrelated, with the strongest correlation among healthy people being traced between lumbar lordosis GLL and the sacrum slope SS (p < 0.001; R = 0.86) [14,17,54,55]. The ideal value of RT (pelvic tilt) does not exceed 50 % of the PI parameter, and the ideal value of the sacrum slope SS exceeds 50 % of PI [55][56][57][58].…”

Section: Discussionmentioning

confidence: 99%

“…High incidence of concurrent pathology of the spine and hip joint that ranges from 28.5 to 70 % [1][2][3][4] as well as a significant number of patients suffering from pain after surgical treatment in the lumbosacral spine (14-50 %) and / or after hip arthroplasty (17-20 %) [2,5,6] led to the formation of a separate nosological group, hip-spine syndrome. At present, it has been proven that the sagittal profile of the trunk strictly correlates with the quality of life [7][8][9][10], and the complex "hip joints and lumbosacral spine" (hereinafter the HJ-LSS complex) plays a key role in the compensatory mechanisms for trunk imbalance [10][11][12][13][14].…”

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confidence: 99%

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Hip-spine syndrome: the problem from the biomechanical point of view

Kotelnikov¹,

Ryabykh²,

Burtsev³

2019

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Relevance Compensatory mechanisms of the lumbar spine-pelvis complex in concurrent degenerative changes remain a poorly understood problem. Numerous publications report data either from the point of view of spinal pathology or from the point of hip joint damage. Objective To evaluate changes in the parameters of the spine-pelvis sagittal balance in patients with the hip-spine syndrome. Materials and methods Two groups of patients with hip-spine syndrome were analysed: 1) "Hipspine" group (n = 54) and 2) "Spine-hip" group (n = 66). All patients underwent radiographic examination. Radiographs of the spine with the capture of the head and hip joints in the anteroposterior and lateral projections in the standing position were taken. Results In the first group, the position of the pelvis was within normal anteversion or pelvic hyperanteversion. In the second group, pelvic retroversion was revealed; normal position of the pelvis (without its compensatory deviation) was present only in several cases. Discussion Regularities in the compensatory mechanisms in the hip-spine syndrome variants have been identified. However, cases with pelvic retroversion require further study and assessment of the balance after surgery. Conclusion Compensatory mechanisms in hip-spine syndrome depend on the dominance of the pathological process (joints or spine), which must be considered in evaluation of the parameters of the sagittal balance in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Hip-spine syndrome: the problem from the biomechanical point of view

Kotelnikov¹,

Ryabykh²,

Burtsev³

2019

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“…considered that if the acetabular anteversion is ≥20° in the supine position, then the hip‐joint prosthesis is relatively stable in the sitting position. Shon et al . reported an individual case who developed dislocation after THA.…”

Section: Significance Of Sagittal Spinopelvic Tilt In the Preoperativmentioning

confidence: 99%

The Influence of Pelvic Tilt on the Anteversion Angle of the Acetabular Prosthesis

Yang

Zhang

2019

Orthopaedic Surgery

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The concept of the “safe area” of the acetabular prosthesis has a long history and has been recognized by many scholars. It is generally believed that postoperative hip dislocation rate is low, when the acetabular anteversion angle is placed in the range of 15° ± 10°. Despite this, hip dislocation is a common complication after total hip arthroplasty. In recent years, more and more scholars have paid attention to the influence of pelvic tilt on the acetabular anteversion angle. The concept of acetabular anteversion changes as the pelvic tilt changes, and is challenging the traditional acetabular prosthesis “safe area.” This study summarized the potential influencing factors of pelvic tilt and discussed the influence of the phenomenon on the anteversion angle of total hip arthroplasty (THA) acetabular prosthesis based on the literature review. We conclude that from the supine position to standing, followed by sitting, the pelvis tends to move backward. Pelvic sagittal activity, lumbar disease (ankylosing spondylitis), lumbar fusion (lumbar fusion, spine‐pelvic fusion), and other factors related to the tilt are THA risk factors for postoperative dislocation and revision. With the change of body position, the degree of acetabular anteversion is directly related to the degree of pelvic tilt. The acetabular anteversion varies greatly, which leads to increased hip prosthesis wear and even hip dislocation. The lateral X‐ray of the spine and pelvis is recommended in supine, standing, and sitting positions before THA. In addition, the pelvic tilt should be regarded as a reference of the acetabular prosthesis in the preoperative planning of THA.

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“…Therefore, the question whether PT angles measured in the supine position are adequate for acetabular cup alignment without an adjustment or without considering individual patient differences is highly relevant [ 10 ]. The accurate knowledge of the spatial orientation of the pelvis in an upright position is extremely important during acetabular cup implantation (mostly performed in supine position), because the pelvis position influences the final hip cup inclination and anteversion angles [ 6 , 11 , 12 ]. The inclination and anteversion angles have been advocated to influence the outcomes and survival rates in THA [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Pelvic Tilt Angle Differences Between Symptom-Free Young Subjects and Elderly Patients Scheduled for THA: The Rationale for Tilt-Adjusted Acetabular Cup Implantation

Marques¹,

Martín²,

Kochman³

et al. 2018

TOORTHJ

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Background:The question whether Pelvic Tilt (PT) angles measured in the supine position are adequate for the alignment of the acetabular cup without an adjustment for anatomical differences between patients is of clinical importance. The aim of this work was to test for factors that can significantly affect PT angles.Methods:In the present retrospective cohort comparison, the PT angles of 12 Symptom-Free Young Subjects (SFYS) and 45 patients scheduled for Total Hip Arthroplasty (THA) were compared. The data was collected during two studies with the use of a novel smartphone-based navigated ultrasound measurement system. Multi-factorial analysis of variance was run to determine which factors significantly affect PT.Results:Body position (F= 126.65; P< 0.001) and group (SFYS vs. THA patients) (F= 17.52; P< 0.001) had significant main effects on PT. There was also a significant interaction between body position and group (F= 25.59; P< 0.001). The mean PT increased by 8.1° from an interiorly to a neutral tilted position (P< 0.001) and 21.4° from a neutral to a posteriorly tilted position (P< 0.001) with the transition from the supine into the upright position for the SFYS and THA patients, respectively.Conclusion:In both groups, PT changed significantly with a transition from the supine to the upright position. A position-dependent mean PT increase in the patient group showed that acetabular cup alignment based on PT in the supine position is not reliable without taking into consideration the inclination of the pelvis in standing position. This may lead to instability and dislocations.

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Can pelvic tilting be ignored in total hip arthroplasty?

Cited by 32 publications

References 12 publications

Hip-spine syndrome: the problem from the biomechanical point of view

Hip-spine syndrome: the problem from the biomechanical point of view

The Influence of Pelvic Tilt on the Anteversion Angle of the Acetabular Prosthesis

Pelvic Tilt Angle Differences Between Symptom-Free Young Subjects and Elderly Patients Scheduled for THA: The Rationale for Tilt-Adjusted Acetabular Cup Implantation

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