Influence of obesity and intra-operative imaging guidance technology on acetabular cup positioning in total hip arthroplasty

Does Body Mass Index (BMI) Affect the Reconstruction of Biomechanical Parameters in Patients Undergoing Total Hip Replacement (THR) through the Direct Anterior Approach (DAA)?

“…A p-value of 0.05 was set as the level of significance. A priori sample size calculation was performed based on a postulated small-to-medium effect size of obesity on the restoration of biomechanical hip parameters, aiming for a statistical power of 0.90, which revealed a total sample size of 58 patients [43].…”

“…With the anticipated increase in the number of obese patients seeking primary THR in the coming years, refinement of surgical techniques and approaches seems imperative [19]. Recently, obesity, as measured by BMI, has been linked to a higher risk for cup malpositioning when performed through the DAA [43]. Trevisan et al were able to demonstrate acceptable reconstruction of HBP a consecutive series of 95 patients undergoing primary THR through the DAA [15].…”

“…We are aware that the number of included patients seems relatively small. However, a priori sample size calculation was performed, and based on a small-to-medium effect size derived from similar studies, a total number of 60 patients seemed sufficient [43]. Correlating the radiographic findings with clinical data would have added additional strength to this study.…”

“…Correlating the radiographic findings with clinical data would have added additional strength to this study. So far, very limited studies have investigated the influence of BMI on cup positioning during DAA-THA [43,55]. Al-Amiry et al were the first to examine the association of BMI with leg-length discrepancy and femoral offset restoration [32].…”