scholarly journals Comparison of the accuracies of computed tomography-based navigation and image-free navigation for acetabular cup insertion in total hip arthroplasty in the lateral decubitus position

2021 ◽  
Vol 26 (1) ◽  
pp. 69-76
Author(s):  
Masahiro Hasegawa ◽  
Shine Tone ◽  
Yohei Naito ◽  
Hiroki Wakabayashi ◽  
Akihiro Sudo
Keyword(s):  
Computed Tomography ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Lateral Decubitus Position ◽  
Acetabular Cup ◽  
Total Hip ◽  
Lateral Decubitus

scholarly journals Is the alignment guide technique in total hip arthroplasty sufficient for accurate cup positioning with a modified Watson Jones approach?

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901880664 ◽  
Author(s):  
Junya Yoshitani ◽  
Takuya Nakamura ◽  
Yoshinobu Maruhashi ◽  
Noriyuki Hashimoto ◽  
Takeshi Sasagawa ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Safe Zone ◽  
Lateral Decubitus Position ◽  
Total Hip ◽  
Logistic Analysis ◽  
Final Sample ◽  
Lateral Decubitus ◽  
Cup Positioning ◽  
Alignment Guide

Purpose: Cup setting with only an alignment guide has been reported to be inaccurate in the lateral decubitus position in total hip arthroplasty (THA). We assessed the accuracy of cup positioning using only the alignment guide technique via a modified Watson Jones approach in the lateral decubitus position. Methods: Two hundred hips of 189 patients underwent THA from October 2014 to September 2016 via a modified Watson Jones approach. In the final sample, 181 hips of 171 patients (35 males, 136 females) were included in this investigation. The alignment of the cup was evaluated by an anteroposterior radiograph of the pelvis 1 week after surgery. Measurements were divided into safe zone determined by Callanan and Lewinnek. Results: There were 168 (92.8%) acetabular cups that were placed within the safe zone for both inclination and anteversion based on the safe zones defined by Lewinnek, and 134 (74%) acetabular cups that were placed within the safe zone defined by Callanan. Multiple logistic analysis showed that the laterality and the addition of the confirmation method were indicators for malpositioning of combined inclination and anteversion. Conclusion: Our data suggested that even if special tools were not used in the lateral decubitus position, using only the alignment guide enabled cup positioning to be achieved with 92.8% accuracy in the Lewinnek safe zone and 74% accuracy in the Callanan safe zone. Multiple logistic analysis showed that the laterality and the addition of a confirmation alignment guide influenced the accuracy of cup positioning.

scholarly journals Direct Anterior Approach for Total Hip Arthroplasty in the Lateral Decubitus Position Versus Supine Position: A Random Clinical Trial

2021 ◽  
Author(s):  
Yao Xiao ◽  
Zhanglai Li ◽  
Feitai Lin ◽  
Yiyuan Zhang ◽  
Yan Weng ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Lateral Position ◽  
Lateral Decubitus Position ◽  
Population Characteristics ◽  
Total Hip ◽  
Lateral Decubitus

Abstract Background: Direct anterior approach (DAA）for total hip arthroplasty (THA）could be performed either in the lateral decubitus position or supine position. However, there is an obvious absence of literature regarding the differences, which position may be more conducive to recovery, technically more demanding, associated with component malposition or more complications. Methods: From Jan.1st, 2020 to oct.1st, 2020, 45 patients were recruited for primary unilateral THA using the DAA. In total, 27 patients (60%) underwent THAs using the DAA in the supine position, and 18 patients (40%) in the lateral decubitus position. All surgeries were performed by a high-volume surgeon. Technical information, clinical and radiographic outcomes, SF-12 and patient-reported outcomes such as WOMAC were evaluated. All the date were tested with Generalized Linear Mixed Models Analysis, GLM Repeated Measurement Analysis, Independent samples t-test or Pearson’s chi-square test.Results: There were no differences in Population characteristics before surgery. The operation time, length of stay and blood loss in the LP group and the SP group were no differences. The prosthesis of the two groups were in a good position. pre-operative and the first and third day after the surgery of CK-MB and Hb,pre-operative and the last follow-up of HSS,WOMAC,UCLA,VAS,SF-12,and pre-operation and post-operation of Offset,FA and LLD, all the above indicators show no significant difference. And the incidence of complications in the lateral position was lower than that in the supine position.Conclusion: Both THA via DAA in the lateral decubitus position and in the supine position produced excellent clinical outcomes. From the perspective of the occurrence of complications, we are more inclined to use the lateral position.

scholarly journals Pelvic tilt and movement during total hip arthroplasty in the lateral decubitus position

2015 ◽  
Vol 26 (3) ◽  
pp. 435-440 ◽  
Author(s):  
Masayuki Kanazawa ◽  
Yasuharu Nakashima ◽  
Masanobu Ohishi ◽  
Satoshi Hamai ◽  
Goro Motomura ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Lateral Decubitus Position ◽  
Total Hip ◽  
Lateral Decubitus

scholarly journals Usefulness of Intraoperative C-Arm Image Intensifier in Reducing Errors of Acetabular Component During Primary Total Hip Arthroplasty: An Application of Widmer’s Method

2021 ◽  
Author(s):  
Joo-Hyoun Song ◽  
Yong-Sik Kim ◽  
Soon-Yong Kwon ◽  
Young-Wook Lim ◽  
Jiyoung Jung ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Intraoperative Imaging ◽  
Harris Hip Score ◽  
Acetabular Cup ◽  
Target Zone ◽  
Total Hip ◽  
3D Computed Tomography

Abstract Background: Acetabular prosthesis positioning in total hip arthroplasty (THA) is crucial in reducing the risk of dislocation. There has been minimal research on the proper way to put the acetabular components into the safe zone intraoperatively. Assessment of version by intraoperative imaging intensifier is very valuable. The value of Widmer’s method, using the intraoperative C-arm available to determine cup anteversion was assessed.Methods: 101 hips in 91 patients who underwent primary THA were eligible for inclusion. Utilizing intraoperative C-arm images, measurement was performed using the technique described by Widmer. The values obtained using 3D computed tomography postoperatively, which determined the anteversion of the acetabular component, were regarded as the reference standard.Results: The method of Widmer obtained values similar to those obtained using 3D computed tomography and was considered accurate (n.s.). All 101 hips were positioned in the set target zone. Among the 101 hips, the cup position in nine hips (8.9%) was changed. The dislocation rate in our study was 1.0% with all dislocations occurring in hips placed in the target zone. The mean Harris hip score after THA in one year was 94.2 (82-98).Conclusions: The method of Widmer was accurate using intraoperative imaging intensifier for the measurement of the anteversion of the acetabular component during THA, with reference to the anteversion obtained from the 3D computed tomography. Also, utilizing intraoperative C-arm imaging was very useful because it allowed for correction of the position of the acetabular cup.

Changes in acetabular orientation during total hip arthroplasty

2019 ◽  
Vol 101-B (6_Supple_B) ◽  
pp. 45-50 ◽  
Author(s):  
D. T. Schloemann ◽  
A. I. Edelstein ◽  
R. L. Barrack
Keyword(s):  
Total Hip Arthroplasty ◽  
Acetabular Component ◽  
Hip Arthroplasty ◽  
Lateral Decubitus Position ◽  
Horizontal Distance ◽  
Component Position ◽  
Total Hip ◽  
Inferior Aspect ◽  
Lateral Decubitus ◽  
The Mean

Aims The aims of this study were to determine the change in pelvic sagittal alignment before, during, and after total hip arthroplasty (THA) undertaken with the patient in the lateral decubitus position, and to determine the impact of these changes on acetabular component position. Patients and Methods We retrospectively compared the radiological pelvic ratio among 91 patients undergoing THA. In total, 41 patients (46%) were female. The mean age was 61.6 years (sd 10.7) and the mean body mass index (BMI) was 20.0 kg/m2 (sd 5.5). Anteroposterior radiographs were obtained: in the standing position preoperatively and at six weeks postoperatively; in the lateral decubitus position after trial reduction intraoperatively; and in the supine position in the post-anaesthesia care unit. Pelvic ratio was defined as the ratio between the vertical distance from the inferior aspect of the sacroiliac (SI) joints to the superior pubic symphysis and the horizontal distance between the inferior aspect of the SI joints. Changes in the apparent component position based on changes in pelvic ratio were determined, with a change of > 5° considered clinically significant. Analyses were performed using Wilcoxon’s signed-rank test, with p < 0.05 considered significant. Results Intraoperatively, in the lateral decubitus position, the pelvic ratio increased (anterior tilt) in 69.4% of cases, did not change significantly in 20.4%, and decreased (posterior tilt) in 10.2% of cases. When six-week postoperative radiographs were compared with preoperative radiographs, the pelvic ratio decreased in 44.9% of cases, did not change significantly in 42.3%, and increased in 12.8% of cases. This change in alignment correlated with a change in acetabular component version of > 5° in 79.6% of cases intraoperatively and 57.7% of cases at six weeks postoperatively. Conclusion Changes in pelvic sagittal pelvic position occur throughout THA that, if unaccounted for, introduce errors in acetabular component placement. The use of intraoperative imaging may help the appropriate placement of the acetabular component. Cite this article: Bone Joint J 2019;101-B(6 Supple B):45–50.

Sign in / Sign up

Export Citation Format

Share Document