scholarly journals Direct Anterior Versus Anterolateral and Posterior Approaches to Total Hip Replacement: Comparative Accuracy of Acetabular Implant Placement and Early Clinical Outcomes

2020 ◽  
Author(s):  
Ying-Lin Chen ◽  
Chi-Horng Horng ◽  
Shang-Lin Hsieh ◽  
Chin-Jung Hsu ◽  
Chien-Chun Chang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Operation Time ◽  
Surgical Approaches ◽  
Anterolateral Approach ◽  
Acetabular Cup ◽  
Total Hip ◽  
Significant Difference ◽  
Cup Position ◽  
Acetabular Cup Position

Abstract BackgroundDifferent surgical approaches used in total hip arthroplasty (THA) include a direct anterior approach (DAA), anterolateral approach (AL), and posterolateral approach (PL). However, the acetabular cup position varies according to surgical view, surgical table, and patient position for each approach. This study is aimed to compare acetabular cup position in THA under different approaches, including surgical time, blood loss, and postoperative complications.MethodsBetween Jan 2017 and Dec 2018, 231 patients who underwent THA (64 DAA, 96 AL, and 71 PL THAs) were analyzed retrospectively. Intraoperative blood loss, operation time, preoperative and postoperative WOMAC score, cup anteversion, inclination angle, and postoperative complications were analyzed.ResultsDAA showed longer operation time and more blood loss, but shorter hospital stays. The cup was found in the safe zone for 97% of DAA patients, 74% of AL patients, and 56% of PL patients. PL showed the highest complication rate (9.9%), followed by DAA (3.1%) and AL (1%). There was no statistically significant difference in preoperative and postoperative WOMAC scores. ConclusionTHA by DAA using a special table is a more reliable procedure to achieve safe cup position. Although DAA showed fewer outliers in cup position, it resulted in longer operation time and greater blood loss compared to other groups.Trial registration: Retrospective study

Direct Anterior Versus Anterolateral and Posterolateral Approaches to Total Hip Replacement: Comparative Accuracy of Acetabular Implant Placement and Early Clinical Outcomes

2021 ◽  
Author(s):  
Ying-Lin Chen ◽  
Chi-Horng Horng ◽  
Shang-Lin Hsieh ◽  
Chin-Jung Hsu ◽  
Chien-Chun Chang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Operation Time ◽  
Surgical Approaches ◽  
Anterolateral Approach ◽  
Acetabular Cup ◽  
Total Hip ◽  
Significant Difference ◽  
Cup Position ◽  
Acetabular Cup Position

Abstract BackgroundDifferent surgical approaches used in total hip arthroplasty (THA) include direct anterior approach (DAA), anterolateral approach (AL), and posterolateral approach (PL). However, the acetabular cup position varies according to surgical view, surgical table, and patient position for each approach. This study is aimed to compare acetabular cup position in THA under different approaches, including surgical time, blood loss, and postoperative complications.MethodsBetween Jan 2017 and Dec 2018, 231 patients who underwent THA (64 DAA, 96 AL, and 71 PL THAs) were analyzed retrospectively. Intraoperative blood loss, operation time, preoperative and postoperative WOMAC score, cup anteversion, inclination angle, and postoperative complications were analyzed.ResultsDAA showed longer operation time and more blood loss, but shorter hospital stays. The cup was found in the safe zone for 97% of DAA patients, 74% of AL patients, and 56% of PL patients. PL showed the highest complication rate (9.9%), followed by DAA (3.1%) and AL (1%). There was no statistically significant difference in preoperative and postoperative WOMAC scores. ConclusionTHA by DAA using a special table is a more reliable procedure to achieve safe cup position. Although DAA showed fewer outliers in cup position, it resulted in longer operation time and greater blood loss compared to other groups.Trial registration: Retrospective study

scholarly journals Acetabular cup position and risk of dislocation in primary total hip arthroplasty

2016 ◽  
Vol 88 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Kurt G Seagrave ◽  
Anders Troelsen ◽  
Henrik Malchau ◽  
Henrik Husted ◽  
Kirill Gromov
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
Cup Position ◽  
Acetabular Cup Position ◽  
Primary Total Hip Arthroplasty

scholarly journals An accelerometer-based navigation system provides acetabular cup orientation accuracy comparable to that of computed tomography-based navigation during total hip arthroplasty in the supine position

2019 ◽  
Author(s):  
Tomonori Tetsunaga ◽  
Kazuki Yamada ◽  
Tomoko Tetsunaga ◽  
Tomoaki Sanki ◽  
Yoshi Kawamura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Supine Position ◽  
Polyethylene Wear ◽  
Anterolateral Approach ◽  
Navigation Systems ◽  
Acetabular Cup ◽  
Total Hip ◽  
Significant Difference

Abstract Background: Inadequate acetabular component orientation is associated with postoperative impingement, dislocation, and accelerated polyethylene wear. Computed tomography (CT)-based navigation systems provide accuracy for total hip arthroplasty (THA) but are not available in all facilities. Accelerometer-based navigation systems are inexpensive, but their accuracy remains undetermined. This study compares the accuracy of cup orientation in THA using CT-based and accelerometer-based navigation systems. Methods: This retrospective study included 35 consecutive patients (11 males, 24 females; mean age, 65 years) who underwent primary cementless THA via an anterolateral approach in the supine position. Both CT-based and accelerometer-based navigation systems were used simultaneously. The accuracy of cup orientation was compared between the two systems using postoperative CT. Results: The accuracy of cup inclination was 2.7° ± 2.0° in the CT-based group and 3.3° ± 2.4° in the accelerometer-based group. The accuracy of cup anteversion was 2.8° ± 2.6° in the CT-based group and 3.4° ± 2.2° in the accelerometer-based group. No significant difference was observed in cup inclination ( p = 0.29) or cup anteversion ( p = 0.34) between CT-based and accelerometer-based navigation. Conclusions: The accuracy of cup positioning did not differ significantly between CT-based and accelerometer-based navigation systems.

scholarly journals Acetabular cup position differs in spinopelvic mobility types: a prospective observational study of primary total hip arthroplasty patients

2021 ◽  
Author(s):  
Henryk Haffer ◽  
Zhen Wang ◽  
Zhouyang Hu ◽  
Christian Hipfl ◽  
Matthias Pumberger
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Sacral Slope ◽  
Acetabular Cup ◽  
Sagittal Vertical Axis ◽  
Total Hip ◽  
Spinal Segments ◽  
Cup Positioning ◽  
Cup Position ◽  
Acetabular Cup Position

Abstract Introduction Spinopelvic mobility was identified as a contributing factor for total hip arthroplasty (THA) instability. The influence of spinopelvic function on acetabular cup positioning has not yet been sufficiently investigated in a prospective setting. Therefore, our study aimed (1) to assess cup inclination and anteversion in standing and sitting based on spinopelvic mobility, (2) to identify correlations between cup position and spinopelvic function, (3) and to determine the influence of the individual spinal segments, spinal sagittal balance, and spinopelvic characteristics on the mobility groups. Materials and methods A prospective study assessing 197 THA patients was conducted with stereoradiography in standing and sitting position postoperatively. Two independent investigators determined cup anteversion and inclination, C7-Sagittal vertical axis, cervical lordosis (CL), thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope, pelvic tilt (PT), anteinclination (AI), and pelvic femoral angle (PFA). Spinopelvic mobility is defined based on ∆PT = PTstanding − PTsitting as ∆PT < 10° stiff, ∆PT ≥ 10–30° normal, and ∆PT > 30° hypermobile. Pearson coefficient represented correlations between the cup position and spinopelvic parameters. Results Significant differences were demonstrated for cup anteversion (stiff/hypermobile 29.3°/40.1°; p < 0.000) and inclination (stiff/hypermobile 43.5°/60.2°; p < 0.000) in sitting, but not in standing position. ∆ (standing/sitting) of the cup anteversion (stiff/neutral/hypermobile 5.8°/12.4°/19.9°; p < 0.000) and inclination (stiff/neutral/hypermobile 2.3°/11.2°/18.8°; p < 0.000) revealed significant differences between the mobility groups. The acetabular cup position in sitting, was correlated with lumbar flexibility (∆LL) and spinopelvic mobility. Significant differences were detected between the mobility types and acetabular orientation (AI sit:stiff/hypermobile 47.6°/65.4°; p < 0.000) and hip motion (∆PFA:stiff/hypermobile 65.8°/37.3°; p < 0.000). Assessment of the spinal segments highlighted the role of lumbar flexibility (∆LL:stiff/hypermobile 9.9°/36.2°; p < 0.000) in the spinopelvic complex. Conclusion The significantly different acetabular cup positions in sitting and in the ∆ between standing and sitting and the significantly altered spinopelvic characteristics in terms of stiff and hypermobile spinopelvic mobility underlined the consideration for preoperative functional radiological assessment. Identifying the patients with altered spinopelvic mechanics due to a standardized screening algorithm is necessary to provide safe acetabular cup positioning. The proximal spinal segments appeared not to be involved in the spinopelvic function.

Effect of Acetabular Cup Position and Orientation in Cemented Total Hip Arthroplasty

2001 ◽  
Vol 388 ◽  
pp. 135-142 ◽  
Author(s):  
Kazuo Hirakawa ◽  
Naoto Mitsugi ◽  
Tomihisa Koshino ◽  
Tomoyuki Saito ◽  
Yasusuku Hirasawa ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Cup ◽  
Total Hip ◽  
Position And Orientation ◽  
Cemented Total Hip Arthroplasty ◽  
Cup Position ◽  
Acetabular Cup Position

scholarly journals Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuan-Wei Zhang ◽  
Xin Xiao ◽  
Wen-Cheng Gao ◽  
Yan Xiao ◽  
Su-Li Zhang ◽  
...  
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Three Dimensional ◽  
Operation Time ◽  
Varus Deformity ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Cubitus Varus ◽  
Guide Plate ◽  
Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

scholarly journals Intraoperative Nice knots assistance for reduction in displaced comminuted clavicle fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fangning Hu ◽  
Xi Liu ◽  
Fanxiao Liu ◽  
Honglei Jia ◽  
Xiaolong Lv ◽  
...  
Keyword(s):  
Blood Loss ◽  
Rating Scale ◽  
Clavicle Fracture ◽  
Operation Time ◽  
Clinical Results ◽  
Intraoperative Blood Loss ◽  
Traditional Group ◽  
Significant Difference ◽  
Clavicle Fractures ◽  
Displaced Clavicle Fracture

Abstract Purpose The Nice knots have been widely used in orthopedic surgeries to fix torn soft tissue and fracture in recent years. The study aims to investigate the clinical efficacy and prognosis of intraoperative and postoperative Nice Knots-assisted reduction in the treatment of displaced comminuted clavicle fracture. Methods From Jan 2014 to Dec 2019, 75 patients diagnosed with unilateral closed displaced comminuted clavicle fracture were treated with open reduction and internal fixation (ORIF) in this study. Nice knot group (the NK group) included 38 patients and the other 37 patients were in the traditional group (the TK group). The time of operation and the amount of bleeding during operation were recorded. Post-operative clinical outcomes and radiographic results were recorded and compared between these two groups. The Visual Analogue Scale (VAS), Neer score, Rating Scale of the American Shoulder and Elbow Surgeons, Constant-Murley score and complications such as infection, nonunion, implant loosening, fragment displacement and hardware pain were observed in the two groups. Results In the comparison between the two groups, there was no significant difference in age, sex, the cause of displaced clavicle fracture, and other basic information between the two groups. The operation time, intraoperative fluoroscopy time, and intraoperative blood loss were significantly reduced in the NK group (P < 0.01). There were 2 cases of plate fracture in the TK group. The follow-up results showed that there was no significant difference in VAS, Neer score, ASES, and Constant-Murley scores between the two groups. Conclusion The use of Nice knot, in comminuted and displaced clavicle fractures can reduce intraoperative blood loss, shorten operation time, facilitate intraoperative reduction, and achieve satisfactory postoperative clinical results. This study demonstrates that Nice knot is a simple, safe, practical and effective auxiliary reduction method.

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