The relationship of the orientation of the transverse acetabular ligament and acetabular labrum to the suggested safe zones of cup positioning in total hip arthroplasty

Archbold, H. A. P.; Slomczykowski, M.; Crone, M.; Eckman, Kort; Jaramaz, Branislav; Beverland, David

doi:10.1177/112070000801800101

Cited by 46 publications

(37 citation statements)

References 36 publications

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“…Several published studies have recommended the use of the TAL for acetabular component positioning (1,2,11). One of these studies reported that the senior author was able to identify the TAL in virtually all primary THA patients despite obscuring soft tissue or inferior acetabular osteophytes.…”

Section: Discussionmentioning

confidence: 98%

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Acetabular Component Positioning Using the Transverse Acetabular Ligament: Can You Find It and Does It Help?

Epstein

Woolson

Giori

2011

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 98%

“…More recently, these same authors examined the orientation of the TAL in MRI studies of nonarthritic hips and found it to lie within 5.3°to 36.1°of version in the sagittal plane [2]. Acetabular component position was within the ''safe zone'' in 14 of 14 hips using the TAL as a guide in cadaveric specimens [11].…”

Section: Introductionmentioning

confidence: 96%

Acetabular Component Positioning Using the Transverse Acetabular Ligament: Can You Find It and Does It Help?

Epstein

Woolson

Giori

2011

Clinical Orthopaedics &Amp; Related Research

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“…14 In patients with labrum injury, anteversion of the acetabular plane (as defined by the TAL-acetabular labrum) was 23º. 13 In a cadaveric study, all hips that used the TAL as the landmark for cup implantations were within the safe zone. 12 Using the acetabular ridge as a reference, the acetabular anteversion was 19.9º, and the actual acetabular anteversion tended to be greater than the conventional safe zone angles, according to the morphology of the acetabulum.…”

Section: Discussionmentioning

confidence: 99%

“…9 However, it has only been used in normal or primary osteoarthritic hips. [10][11][12][13] It may not be applicable to hips with severe deformity secondary to developmental dysplasia or congenital dislocation. In addition, the TAL is difficult to visualise intraoperatively.…”

mentioning

confidence: 99%

Using the Transverse Acetabular Ligament as a Landmark for Acetabular Anteversion: An Intraoperative Measurement

Inoue

Majima

Abe

et al. 2013

J Orthop Surg (Hong Kong)

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purpose. To measure the transverse acetabular ligament (TAL) anteversion in hips with severe deformity, using fluoroscopy-computed tomographic navigation. Methods. 31 hips in 10 men and 19 women aged 40 to 78 (mean, 58.7) years who underwent total hip arthroplasty for primary osteoarthritis (n=6) or osteoarthritis secondary to developmental hip dysplasia (n=19) or congenital hip dislocation (n=6) were included. The severity of hip dislocation was classified according to the Crowe classification; 15 hips were grade 1, 7 were grade 2, 3 were grade 3, and 6 were grade 4. The TAL anteversion was measured using fluoroscopy-computed tomographic navigation. The difference in TAL anteversion between non-dislocated hips (Crowe grade 1, n=15) and dislocated hips (Crowe grades 2-4, n=16) was compared. results. In all 31 hips, the TAL could be visualised intra-operatively. No patient reported severe pain, Using the transverse acetabular ligament as a landmark for acetabular anteversion: an intraoperative measurement early wear, loosening, or dislocation after 2 years. The mean TAL anteversion and inclination angles measured by the navigation system were 26.5º (SD, 8.9º; range, and 41.5º (SD, 4.6º; range, 32º-49º), respectively. 22 of the 31 hips were in the safe zone. TAL anteversion in non-dislocated and dislocated hips was not significantly different. Interand intra-observer mean absolute differences in TAL anteversion were 0.3º and 0.4º, respectively. conclusion. The TAL is a useful anatomic landmark for total hip arthroplasty in dislocated hips.

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“…MRI studies have shown that the natural anteversion of the TAL in healthy subjects ranges from 5.3° to 36.1° which would render this landmark useless in judging cup placement. 24 Furthermore, natural acetabular position in the native hip is inconsistent and known to change with osteoarthritis, dysplasia and osteonecrosis. A study of the natural orientation of the acetabulum in arthritic hips showed a smaller angle of inclination and anteversion for both sexes.…”

Section: Acetabular Cup Placement Prior To Computer Navigation In Thamentioning

confidence: 99%

Computer navigation of the acetabular component in total hip arthroplasty: a narrative review

Davenport

Kavarthapu

2016

EFORT Open Reviews

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Total hip arthroplasty (THA) is a common procedure for primary osteoarthritis, but increasing numbers are also being performed for other pathologies such as secondary arthritis, inflammatory arthropathies and trauma. Estimates suggest that around 8.5 million people in the UK are affected by joint pain secondary to arthritis and a rising ageing population has resulted in an increase in THA operations of around 4% per year over the last six years.Multiple studies have shown that THA provides improved quality of life scores, but there remains the burden of complications which account for 15% of £1bn NHS liability payouts. DaPalma et al analysed the financial impact of complications following THA and found the additional cost of a dislocation within six weeks of surgery is 342% of the primary cost.Following primary THA, complications may occur as a result of incorrect component positioning of the femoral stem, the acetabular cup or both. It is known that acetabular malposition may lead to increased rates of dislocation, impingement, edge-loading, polyethylene wear, pelvic osteolysis and prosthesis failure.Acetabular component positioning has been described as the single most important factor in dictating risk of dislocation following THA. Furthermore, instability and dislocation after primary THA is the most common single reason for revision surgery accounting for 22.5% of all revisions and 33% of acetabular revisions.We outline the currently available methods of acetabular navigation comparing freehand techniques with computer and robotic-assisted navigation of the acetabular component.Cite this article: Davenport D, Kavarthapu V. Computer navigation of the acetabular component in total hip arthroplasty: a narrative review. EFORT Open Rev 2016;1:279-285. DOI: 10.1302/2058-5241.1.000050.

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The relationship of the orientation of the transverse acetabular ligament and acetabular labrum to the suggested safe zones of cup positioning in total hip arthroplasty

Cited by 46 publications

References 36 publications

Acetabular Component Positioning Using the Transverse Acetabular Ligament: Can You Find It and Does It Help?

Acetabular Component Positioning Using the Transverse Acetabular Ligament: Can You Find It and Does It Help?

Using the Transverse Acetabular Ligament as a Landmark for Acetabular Anteversion: An Intraoperative Measurement

Computer navigation of the acetabular component in total hip arthroplasty: a narrative review

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