Influence of pelvic sagittal tilt on 3-dimensional bone coverage in total hip arthroplasty: a simulation analysis

2019 ◽  
Vol 30 (3) ◽  
pp. 288-295
Author(s):  
Takuro Ueno ◽  
Tamon Kabata ◽  
Yoshitomo Kajino ◽  
Tomoharu Takagi ◽  
Takaaki Ohmori ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Orientation Angle ◽  
Acetabular Coverage ◽  
3 Dimensional ◽  
Total Hip ◽  
Sagittal Tilt ◽  
Posterior Tilt ◽  
3D Coverage

Background: In total hip arthroplasty with computer navigation assistance, cup orientation is generally determined according to the coordinate system relative to the functional pelvic plane (FPP). However, there is a large difference in the cup anteversion between a posterior pelvic tilt relative to the computed tomography (CT) table in the sagittal plane and anterior pelvic tilt, even when the cup is set at the same orientation angle according to each FPP. The present study analysed this difference from the viewpoint of 3-dimensional (3D) coverage of the acetabular component (3D coverage) to determine how the 3D acetabular coverage is altered with changes in pelvic sagittal tilt. Methods: We analysed 3D-simulated acetabular coverage measured in 3D pelvic models reconstructed from the preoperative CT data of 50 patients. In each patient, we created 5 pelvic models with a sagittal tilt of 10° increments between 20° anterior tilt and 20° posterior tilt relative to the CT table. Results: We found that 3D coverage decreased as the pelvis tilted posteriorly. Particularly, there were significant differences between the pelvis with 20° anterior tilt and that with neutral tilt ( p < 0.001). There was also a difference between the pelvis with neutral tilt and that with a 20° posterior tilt ( p < 0.01). The mean decrease in 3D coverage between the pelvis with neutral tilt and that with 20° posterior tilt was 7.2 ± 1.6%. Conclusions: We found that 3D coverage differed among pelvis with different sagittal tilts when the cup orientation angle was determined according to FPP.

scholarly journals Proposal of accurate cup placement procedure during total hip arthroplasty based on pelvic tilt discrepancies in the lateral position

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Manabu Tsukamoto ◽  
Makoto Kawasaki ◽  
Hitoshi Suzuki ◽  
Teruaki Fujitani ◽  
Akinori Sakai
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Lateral Position ◽  
Correction Formula ◽  
Total Hip ◽  
Sagittal Tilt ◽  
Pelvic Movement ◽  
Pelvic Position ◽  
Navigation Accuracy

AbstractBy combining the anatomical-pelvic-plane (APP) positioner with a newly improved navigation system during total hip arthroplasty (THA), it is theoretically possible to determine cup orientation based on the APP while tracking pelvic movement. The purpose of this study was to determine the navigation accuracy and whether the error is related to the pelvic position fixed by the positioner. Fifty hips that underwent primary THA between 2018 and 2020 were analysed. The accuracy was 2.34° at radiographic inclination (RI) and − 5.01° at radiographic anteversion (RA), and the error was within 10° at both RI and RA in only 40 of 50 hips (80.0%). The discrepancy in pelvic sagittal tilt was correlated with the cup orientation error and especially strongly correlated with the RA error (r = − 0.751, p < 0.001). When RI and RA were calculated using a correction formula to determine the true cup orientation based on the pelvic tilt discrepancies, the error in both RI and RA was within 10° in all cases (100%). The navigation accuracy is related to the pelvic position fixed by the positioner, and the correction formula for the target angle that considers pelvic tilt discrepancies can lead to accurate cup placement in the future.

scholarly journals Pelvic Tilt in Patients Undergoing Total Hip Arthroplasty: When Does it Matter?

2015 ◽  
Vol 30 (3) ◽  
pp. 387-391 ◽  
Author(s):  
Joseph D. Maratt ◽  
Christina I. Esposito ◽  
Alexander S. McLawhorn ◽  
Seth A. Jerabek ◽  
Douglas E. Padgett ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Total Hip

Effects of posterior pelvic tilt on anterior instability in total hip arthroplasty: A parametric experimental modeling evaluation

2013 ◽  
Vol 28 (2) ◽  
pp. 178-181 ◽  
Author(s):  
Taishi Sato ◽  
Yasuharu Nakashima ◽  
Akinobu Matsushita ◽  
Masanori Fujii ◽  
Yukihide Iwamoto
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Experimental Modeling ◽  
Anterior Instability ◽  
Total Hip

Is computerised 3D templating more accurate than 2D templating to predict size of components in primary total hip arthroplasty?

2018 ◽  
Vol 29 (3) ◽  
pp. 270-275 ◽  
Author(s):  
Erik Schiffner ◽  
David Latz ◽  
Pascal Jungbluth ◽  
Jan P Grassmann ◽  
Stephan Tanner ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Preoperative Diagnosis ◽  
3 Dimensional ◽  
Total Hip ◽  
Primary Thas ◽  
Implant Size ◽  
The Difference ◽  
Primary Total Hip Arthroplasty

Introduction: The aim of this study was to compare the accuracy of preoperative templating in total hip arthroplasty (THA) using conventional 2-dimensional (2D) and computed tomography (CT)-based 3-dimensional (3D) measures. Methods: One hundred and sixteen consecutive primary THAs were analysed. The preoperative diagnosis was primary osteoarthritis in all cases. The 2D templating and the 3D templating were performed by two different residents. All templating results were available for the orthopaedic surgeon performing the procedure. Accuracies with regard to the predicted and actual implant sizes were determined for each procedure. Implantation of the size as planned was defined as “exact”, whereas the use of components within one size larger or smaller (±1) as planned were defined as “accurate.” Results: The 3D templating was significantly more accurate in predicting implant sizing compared to 2D templating for primary total hip arthroplasty (THA). The difference was statistically significant for the cup templating (‘‘exact’’ p = 0.02; ‘‘accurate’’ p = 0.01) and for the stem templating (‘‘exact’’ p = 0.04; ‘‘accurate’’ p = 0.01). Conclusion: Our results support the superiority of 3D templating over 2D templating in predicting implant size.

Predictability of Pelvic Tilt During Total Hip Arthroplasty Using a Traction Table

2018 ◽  
Vol 33 (8) ◽  
pp. 2556-2559
Author(s):  
Paul S. Roettges ◽  
Jack R. Hannallah ◽  
Jordan L. Smith ◽  
John T. Ruth
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Total Hip

scholarly journals Axial pelvic tilt in direct anterior Total hip Arthroplasty using a traction table

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Aichmair ◽  
M. Dominkus ◽  
J. G. Hofstaetter
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Pelvic Tilt ◽  
Patient Positioning ◽  
Direct Anterior Approach ◽  
Operating Table ◽  
Inclusion Criteria ◽  
Single Institution ◽  
Total Hip

Abstract Background Direct anterior approach total hip arthroplasty may be undertaken on a traction table, but the effects that patient positioning can have on axial pelvic tilt (aPT) are unknown. The aim of this study was to assess the degree of error from patient positioning on the traction table during anterior minimally-invasive surgery (AMIS) THA. Methods Patients were included who underwent direct anterior THA via the AMIS technique at a single institution between 11/2018 and 03/2019. Axial pelvic tilt was measured (a) in the supine position on the operating table, and (b) after positioning on the traction table, by the same consultant surgeon in all cases. Results In the above-mentioned study period, 50 patients (F: 32; M: 18) with an average age of 60.6 ± 13.6 (range: 26.5 to 88.3) years, and an average BMI of 27.2 ± 5.0 (range: 17.9 to 41.5) kg/m2 met the inclusion criteria. When measured in supine position, the average aPT was − 0.2 ± 1.7 (range: − 5.6 to 3.8) degrees. After positioning on the traction table, the average aPT was − 3.5 ± 2.1 (− 8.5 to 1.6) degrees (p < 0.001). In patients with an aPT of more than 5 degrees, the caput-collum-diaphyseal (CCD) angle was significantly lower (125 ± 11° vs. 134 ± 8°, p = 0.007). Conclusion This study raises awareness for the potential risk of aPT during positioning of the patient on the traction table, commonly used during direct anterior THA via the AMIS technique.

scholarly journals Utility of CT-based navigation in revision total hip arthroplasty for a patient with severe posterior pelvic tilt-case report-

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Shintaro Watanabe ◽  
Hyonmin Choe ◽  
Naomi Kobayashi ◽  
Hiroyuki Ike ◽  
Daigo Kobayashi ◽  
...  
Keyword(s):  
Case Report ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Revision Total Hip Arthroplasty ◽  
Total Hip

scholarly journals Late Anterior Dislocation Due to Posterior Pelvic Tilt in Total Hip Arthroplasty

2016 ◽  
Vol 10 (1) ◽  
pp. 206-212 ◽  
Author(s):  
Hiroki Kobayashi ◽  
Yasuharu Nakashima ◽  
Takuaki Yamamoto ◽  
Goro Motomura ◽  
Masayuki Kanazawa ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Conservative Treatment ◽  
Hip Arthroplasty ◽  
Pelvic Tilt ◽  
Compression Fracture ◽  
Anterior Dislocation ◽  
Minor Trauma ◽  
Thoracolumbar Kyphosis ◽  
Acetabular Cup ◽  
Total Hip

Background: Excessive pelvic tilt may be one of the factors leading to instability in total hip arthroplasty (THA), even when the acetabular cup is placed properly. To our knowledge, only a few studies have described late anterior dislocation due to posterior pelvic tilt. We present 3 cases with late anterior dislocations possibly due to posterior pelvic tilt. Cases Presentations: Case-1: An 84-years-old woman fell and presented with an anterior dislocation 12-years after THA. Her pelvis had tilted to approximately 30° posteriorly in a supine position. After conservative treatment, she presented with 10 recurrent anterior dislocations. She had thoracolumbar kyphosis due to multiple compression fractures. Revision with anterior placement of an elevated liner and a 32-mm head corrected the dislocation, and no further dislocations occurred. Case-2: A 78-years-old woman fell and presented with an anterior dislocation 4-years after THA. Her posterior pelvic tilt had increased 23° due to a lumbar compression fracture. Revision by decreasing the cup anteversion was performed, but recurrent posterior dislocations occurred. Owing to her worsened general condition, further treatment was abandoned. Case-3: A 79-years-old woman twisted her body and presented an anterior dislocation 3-years after THA. After manual reduction and conservative treatment, the dislocation recurred. Her posterior pelvic tilt had increased 16°. Conclusion: Although minor trauma triggered the anterior instability in these patients, the underlying pathomechanism existed in the progressive pelvic posterior tilt due to thoracolumbar kyphosis. As longer life expectancy as well as implant survivorship is predicted, attention must be paid to the change of pelvic tilt in elderly patients.

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