Is It Necessary to Obtain Lateral Pelvic Radiographs in Flexed Seated Position for Preoperative Total Hip Arthroplasty Planning?

Pour, Aidin Eslam; Green, Jordan H.; Christensen, Thomas H.; Muthusamy, Nishanth; Schwarzkopf, Ran

doi:10.1016/j.artd.2023.101133

Cited by 2 publications

(2 citation statements)

References 33 publications

(44 reference statements)

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“…Dangerous anatomy such as low PI, spine stiffness, flatback deformity, and excessive standing retroversion of the pelvis are the most prevalent risk factors for dislocation [ 17 , 41 , 45 ]. Imbalance is identified on standing lateral images while mobility is better assessed comparing standing to deep-flexed sitting radiographs and using lumbar flexion [ 34 ].…”

Section: Management Algorithmsmentioning

confidence: 99%

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Current Concepts in Diagnosis and Management of Patients Undergoing Total Hip Replacement with Concurrent Disorders of Spinopelvic Anatomy: A Narrative Review

Ambrus,

Douša,

Almási

et al. 2023

Medicina

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Despite the high success rate of primary total hip replacement (THR), a significant early revision rate remains, which is largely attributed to instability and dislocations. Despite the implants being placed according to the safe zone philosophy of Lewinnek, occurrence of THR dislocation is not an uncommon complication. Large diagnostic and computational model studies have shown variability in patients’ mobility based on the individual anatomic and functional relationship of the hip–pelvis–spine complex. The absolute and relative position of hip replacement components changes throughout motion of the patient’s body. In the case of spinopelvic pathology such as spine stiffness, the system reaches abnormal positional states, as shown with computerized models. The clinical result of such pathologic hip positioning is edge loading, implant impingement, or even joint dislocation. To prevent such complications, surgeons must change the dogma of single correct implant positioning and take into account patients’ individualized anatomy and function. It is essential to broaden the standard diagnostics and their anatomical interpretation, and correct the pre-operative surgical planning. The need for correct and personalized implant placement pushes forward the development and adaptation of novel technologies in THR, such as robotics. In this current concepts narrative review, we simplify the spinopelvic biomechanics and pathoanatomy, the relevant anatomical terminology, and the diagnosis and management algorithms most commonly used today.

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Section: Management Algorithmsmentioning

confidence: 99%

“…To assess mobility of the spinopelvic junction, lateral standing and seated radiographs are used. The deep-flexed position is closer to the functional position of a patient trying to stand up and, when compared to the relaxed-seated position, is more accurate in diagnosing spinal stiffness [ 33 , 34 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

Current Concepts in Diagnosis and Management of Patients Undergoing Total Hip Replacement with Concurrent Disorders of Spinopelvic Anatomy: A Narrative Review

Ambrus,

Douša,

Almási

et al. 2023

Medicina

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Comparative analysis of the developed method of preoperative planning in primary hip arthroplasty

Varfolomeev

2024

Science and Innovations in Medicine

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Aim – to assess the accuracy of the developed method of preoperative planning in hip replacement. Materials and methods. "Method of preoperative planning in hip arthroplasty" was developed to improve the accuracy of preoperative planning and reduce the number of complications. A clinical study was conducted in the comparison groups. In the main group (50 patients), preparation for the operation was carried out using the proposed method, in the control method - using a standard planning method. Accuracy of evaluation of implant sizes, limb length, offset was evaluated in the study. The preoperative planning data were compared with the results obtained. Results. The accuracy of offset estimation in the main group was higher than in the control group (T-criterion = -2.6; p = 0.01). The average difference between the estimated offset and the one obtained in the main group was 1.4±1.5 mm, in the control group it was 2.2±1.7 mm. The error in head size estimation in the main group was less than in the control group (odds ratio = 3.02). There were no significant differences in determining the size of components of the endoprosthesis, and there were no differences in the leg length in the comparison groups. Conclusion. The study demonstrated that the developed method allows improving the accuracy of preoperative planning in hip arthroplasty. The proposed device ensures the correct placement of patients when performing pelvic radiography, and also makes it easy to change it when performing this procedure.

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Is It Necessary to Obtain Lateral Pelvic Radiographs in Flexed Seated Position for Preoperative Total Hip Arthroplasty Planning?

Cited by 2 publications

References 33 publications

Current Concepts in Diagnosis and Management of Patients Undergoing Total Hip Replacement with Concurrent Disorders of Spinopelvic Anatomy: A Narrative Review

Current Concepts in Diagnosis and Management of Patients Undergoing Total Hip Replacement with Concurrent Disorders of Spinopelvic Anatomy: A Narrative Review

Comparative analysis of the developed method of preoperative planning in primary hip arthroplasty

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