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Safe zone total hip

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https://www.readbyqxmd.com/read/29792206/is-the-cup-orientation-different-in-bilateral-total-hip-arthroplasty-with-right-handed-surgeons-using-posterolateral-approach
#1
Xinggui Song, Ming Ni, Heng Li, Xin Li, Xiang Li, Jun Fu, Jiying Chen
BACKGROUND: The impact of surgeon handedness on acetabular cup orientation in total hip arthroplasty (THA) is not well studied. The aim of our study is to investigate the difference of cup orientation in bilateral THA performed by right-handed surgeons using posterolateral approach and which cup could be fitter to Lewinneck's safe zone. METHODS: The study consisted of 498 patients that underwent bilateral THA by three right-handed surgeons in our hospital. Postoperative acetabular cup anteversion and abduction on an anteroposterior pelvic radiograph were measured by Orthoview software (Orthoview LLC, Jacksonville, Florida)...
May 23, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29756497/relationship-between-muscular-and-bony-anatomy-in-native-hips-a-theoretical-background-for-approach-specific-implant-positioning
#2
Doruk Akgün, Philipp von Roth, Tobias Winkler, Carsten Perka, Adam Trepczynski, Bernd Preininger
INTRODUCTION: The aim of this study was to analyse the relationship between bony joint orientation and the distribution of hip musculature. METHODS: The bone anatomy of the hip (femoral antetorsion (AT), acetabular anteversion (AV), and combined anteversion (AV/AT)) and the muscle volume of the gluteal muscles and the tensor fasciae latae were analysed bilaterally using computed tomography data of 49 patients. Muscle force direction (MFD) was determined for each muscle...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29529664/the-safe-zone-range-for-cup-anteversion-is-narrower-than-for-inclination-in-tha
#3
William S Murphy, Ho Hyun Yun, Brett Hayden, Jens H Kowal, Stephen B Murphy
BACKGROUND: Cup malposition is a common cause of impingement, limitation of ROM, acceleration of bearing wear, liner fracture, and instability in THA. Previous studies of the safe zone based on plain radiographs have limitations inherent to measuring angles from two-dimensional projections. The current study uses CT to measure component position in stable and unstable hips to assess the presence of a safe zone for cup position in THA. QUESTIONS/PURPOSES: (1) Does acetabular component orientation, when measured on CT, differ in stable components and those revised for recurrent instability? (2) Do CT data support historic safe zone definitions for component orientation in THA? METHODS: We identified 34 hips that had undergone revision of the acetabulum for recurrent instability that also had a CT scan of the pelvis between August 2003 and February 2017...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29525344/prevention-of-dislocation-after-total-hip-arthroplasty
#4
Fiachra E Rowan, Biju Benjamin, Jurek R Pietrak, Fares S Haddad
BACKGROUND: Prevention of dislocation after primary total hip arthroplasty (THA) begins with patient preoperative assessment and planning. METHODS: We performed a literature search to assess historical perspectives and current strategies to prevent dislocation after primary THA. The search yielded 3458 articles, and 154 articles are presented. RESULTS: Extremes of age, body mass index >30 kg/m2 , lumbosacral pathology, surgeon experience, and femoral head size influence dislocation rates after THA...
May 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29523442/investigation-of-the-unstable-total-hip-arthroplasty
#5
R Michael Meneghini
The investigation of recurrent instability after total hip arthroplasty requires a thorough history and physical examination focused on characterizing the dislocation events and the patient factors that contribute to instability. Radiographic studies include plain radiographs, in particular a cross-table lateral, and computed tomography to accurately assess the implant orientation relative to the patient's native anatomy. More advanced imaging such as magnetic resonance imaging may be useful to assess abductor tendon integrity...
May 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29250498/perioperative-comparison-of-hip-arthroplasty-using-the-direct-anterior-approach-with-the-posterolateral-approach
#6
Sang Hong Lee, Sin Wook Kang, Suenghwan Jo
Purpose: The aim of the current study is to report the advantage and disadvantage of total hip arthroplasty performed in direct anterior approach (DAA) by comparing it to the posterolateral approach (PLA). Materials and Methods: Twenty-five hip arthroplasty done in DAA (12 total hip arthroplasty [THA] and 13 bipolar hemiarthroplasty [BHA]) were compared with the same number done in PLA (13 THA and 12 BHA). Intraoperative assessments including operation time, anesthetic time, bleeding amount were recorded with intraoperative complications...
December 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/29048695/evaluation-of-late-redislocation-in-patients-who-underwent-open-reduction-and-pelvic-osteotomy-as-treament-for-developmental-dysplasia-of-the-hip
#7
Ümit Tuhanioğlu, Hakan Cicek, Hasan U Ogur, Firat Seyfettinoglu, Ahmet Kapukaya
INTRODUCTION: The goal in the treatment of developmental dysplasia of the hip (DDH) is to achieve a stable and concentric reduction and to create a congruent relationship between the femoral head and the acetabulum. This study discusses the causes of loss of reduction in DDH patients who had a concentrically reduced hip at the time of removal of the hip spica cast and cessation of brace use and who later appeared with hip redislocation after mobilisation and ambulation. In addition, the possible interventions in such cases are also discussed...
October 16, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28971085/radiographic-evaluation-of-cementation-technique-using-polished-conical-triple-tapered-femoral-stem-in-hip-arthroplasty
#8
Ademir Antônio Schuroff, Mark Deeke, Marco Antônio Pedroni, Fernando Silva Lupselo, Rodrigo Ernesto Kunz, Alexandre Matos Lima
OBJECTIVE: To radiographically evaluate the quality of cementation and implantation technique using a polished, triple-tapered femoral stem in total hip arthroplasty (THA). METHOD: Retrospective study with radiographic evaluation of 86 hips in 83 patients who underwent to primary THA with the triple-tapered cemented femoral stem C-Stem (DePuy Orthopedics, Warsaw, Indiana). Cases with at least one-year of follow-up were included, and data related to preoperative, immediate postoperative, and late postoperative radiographic evolution were recorded...
2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28939031/the-current-knowledge-on-spinopelvic-mobility
#9
REVIEW
Zachary C Lum, John G Coury, Jonathan L Cohen, Lawrence D Dorr
Recent studies may suggest that our conventional knowledge of risk factors for dislocation may need rethinking. Previous studies have demonstrated a large majority of total hip arthroplasty instability with acetabular cups implanted in safe zones. Recently discovered spinopelvic motion is a coordinated biomechanical relationship among acetabular anteversion, pelvic tilt, and lumbar lordosis. Classification includes normal, hypermobile, stiff, stuck standing, stuck sitting, and fused. Normal spinopelvic motion from standing to sitting occurs with hip flexion, posterior sacral tilt, and decreased lumbar lordosis to accommodate a flexed femur and prevent impingement and dislocation...
January 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28933329/-mid-term-to-long-term-results-of-revision-total-hip-arthroplasty-using-the-oval-shaped-acetabular-cup-tc-type
#10
E Šťastný, T Trč, J Frýdl, Z Kopečný, T Philippou, J Lisý
INTRODUCTION The purpose of our paper is to evaluate the mid-term to long-term results and to confirm the basic criteria of a high-quality revision implant: safe bridging of bone defects, achievement of reliable primary fixation of revision acetabular cup, achievement of good secondary stability with documentable osteointegration of cup and demonstration of remodelling of transplanted bone tissue in the area of defects and in spaces between the implant ribs. MATERIAL AND METHODS Altogether 36 patients (38 cups) were evaluated who had undergone revision hip arthroplasty in the period from 2004 to 2010...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28782077/a-retrospective-study-on-the-relationship-between-altered-native-acetabular-angle-and-vertical-implant-malpositioning
#11
Jorge Rojas, Maria Bautista, Guillermo Bonilla, Omar Amado, Elina Huerfano, Daniel Monsalvo, Adolfo Llinás, José Navas
PURPOSE: Acetabular cup positioning in extreme angles of vertical position affects both stability and long-term survivorship of total hip arthroplasty. The purpose of this study is to determine whether native Sharp's angle is associated with an increased abduction angle of the acetabular component. METHODS: Consecutive patients who underwent primary total hip replacement between February 2012 and August 2015 were included. Vertical positioning of acetabular implant in the antero-posterior post-operative radiographs were measured...
April 2018: International Orthopaedics
https://www.readbyqxmd.com/read/28731487/intraoperative-fluoroscopy-with-a-direct-anterior-approach-reduces-variation-in-acetabular-cup-abduction-angle
#12
Gens P Goodman, Nitin Goyal, Nancy L Parks, Robert H Hopper, William G Hamilton
INTRODUCTION: The purpose of this study was to compare acetabular cup position for 2 cohorts of total hip arthroplasty (THA) patients who had a direct anterior approach. METHODS: 100 THA cases were performed with an anterior approach using intraoperative fluoroscopy (IF) to aid in cup positioning. Another group of 100 cases underwent THA with an anterior approach without the use of any fluoroscopy. Postoperative abduction and anteversion angles were measured using Martell's hip analysis software...
November 21, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28697862/acetabular-and-femoral-anteversions-in-standing-position-are-outside-the-proposed-safe-zone-after-total-hip-arthroplasty
#13
Jean Y Lazennec, Frederic Thauront, Christopher B Robbins, Aidin E Pour
BACKGROUND: Although most hip dislocations occur in either standing or sitting position, the safe zone for implant position is defined for the supine position. Our goal was to determine preoperative and postoperative pelvis and hip orientations and whether the safe zone defined in supine position can be used to assess standing radiographs. METHODS: Preoperative and postoperative three-dimensional EOS images were assessed in 66 total hip arthroplasty patients. None of the patients had dislocation within the follow-up period (12-36 months)...
November 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28641967/fluoroscopically-guided-acetabular-component-positioning-does-it-reduce-the-risk-of-malpositioning-in-obese-patients
#14
Raul G Gosthe, Juan C Suarez, Colin A McNamara, Cecilia Calvo, Preetesh D Patel
BACKGROUND: Obesity has been described as an independent risk factor for acetabular component malpositioning. The purpose of this study was to determine if this could be overcome by use of fluoroscopic navigation in total hip arthroplasty (THA). METHODS: The first, postoperative, standing, anteroposterior pelvis radiographs from 1599 consecutive patients who underwent fluoroscopic-guided THAs via anterior approach during a six-year period were obtained. We retrospectively reviewed this prospectively collected data...
May 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28629942/can-a-target-zone-safer-than-lewinnek-s-safe-zone-be-defined-to-prevent-instability-of-total-hip-arthroplasties-case-control-study-of-56-dislocated-tha-and-93-matched-controls
#15
N Reina, S Putman, R Desmarchelier, E Sari Ali, P Chiron, M Ollivier, J Y Jenny, D Waast, C Mabit, E de Thomasson, C Schwartz, P Oger, L E Gayet, H Migaud, N Ramdane, M H Fessy
BACKGROUND: Various factors contribute to instability of total hip arthroplasty (THA), with implant orientation being a major contributor. We performed a case-control study with computed tomography (CT) data to determine whether: 1) orientation contributes to THA instability and 2) a safer target zone for stability than Lewinnek's classic safe zone can be defined. MATERIAL AND METHODS: We included prospectively 363 cases of THA dislocation that occurred during the calendar 2013 year in 24 participating hospitals...
June 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28625687/can-surgeons-reduce-the-risk-for-dislocation-after-primary-total-hip-arthroplasty-performed-using-the-posterolateral-approach
#16
Kurt G Seagrave, Anders Troelsen, Bjørn G Madsen, Henrik Husted, Thomas Kallemose, Kirill Gromov
BACKGROUND: Hip dislocation is one of the most common postoperative complications after total hip arthroplasty (THA). Potential contributors include patient- and surgical-related factors. We performed a retrospective cohort study to identify risk factors for postoperative dislocation in patients receiving THA via the posterolateral approach. METHODS: We assessed 1326 consecutive primary THAs performed between 2010 and 2015. Patient information was documented, and plain radiographic films were used to evaluate cup positioning, hip offset, and hip length change...
October 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28623889/surgical-accuracy-function-and-quality-of-life-of-simultaneous-versus-staged-bilateral-total-hip-arthroplasty-in-patients-with-osteonecrosis-of-the-femoral-head
#17
Seung-Chan Kim, Young-Wook Lim, Woo-Lam Jo, Dong-Chul Park, Jin-Woo Lee, Won-Woo Kang, Yong-Sik Kim
BACKGROUND: The optimal surgical option for patients requiring bilateral hip replacement remains controversial. The purpose of this study was to compare surgical accuracy; functional outcome and health-related quality of life; and prosthetic-related complications and revision surgery of a simultaneous bilateral total hip arthroplasty (THA) with those of a staged bilateral THA with an interval between procedures <12 months. METHODS: A total of 123 unselected consecutive patients (mean age, 43...
June 17, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28574117/combined-anteversion-technique-in-total-hip-arthroplasty-for-crowe-iv-developmental-dysplasia-of-the-hip
#18
Biao Zhu, Changzheng Su, Yeteng He, Xingyu Chai, Zhen Li, Zhenyang Hou, Tengteng Lou, Xinfeng Yan
BACKGROUND: A high rate of postoperative dislocation in total hip arthroplasty (THA) for Crowe IV developmental dysplasia of the hip (DDH) has been reported, 1 of the main reasons being higher true acetabular anteversion. If the cup is fixed with normal anteversion, the anterior rim will be excessively exposed, which reduces the contact areas of the cup and bone, affects prosthesis stability, and leads to iliopsoas tendinitis and persistent hip pain after THA. The aim of this study was to demonstrate that when cup anteversion is larger, adjusting femoral anteversion to bring the combined anteversion (CA) into the "safe zone" might prevent dislocation...
November 21, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28567577/does-the-surgical-approach-influence-the-implant-alignment-in-total-hip-arthroplasty-comparative-study-between-the-direct-anterior-and-the-anterolateral-approaches-in-the-supine-position
#19
Yuya Kawarai, Satoshi Iida, Junichi Nakamura, Yoshiyuki Shinada, Chiho Suzuki, Seiji Ohtori
PURPOSE: The purpose of this study was to clarify the difference in implant alignment between the direct anterior approach (DAA) and the anterolateral approach in the supine position (ALS). METHODS: A retrospective comparative study consisted of 215 consecutive primary total hip arthroplasties using tapered polished and straight cemented-stems via two different minimally invasive approaches (DAA group in 106 hips and ALS group in 109 hips). RESULTS: The cup radiographic anteversion angle was significantly lower in the ALS group than in the DAA group (12...
December 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28559196/quantifying-pelvic-motion-during-total-hip-arthroplasty-using-a-new-surgical-navigation-device
#20
Ran Schwarzkopf, Jeffrey M Muir, Wayne G Paprosky, Scott Seymour, Michael B Cross, Jonathan M Vigdorchik
BACKGROUND: Accurate cup positioning is one of the most challenging aspects of total hip arthroplasty (THA). Undetected movement of the patient during THA surgery can lead to inaccuracies in cup anteversion and inclination, increasing the potential for dislocation and revision surgery. Investigations into the magnitude of patient motion during THA are not well represented in the literature. METHODS: We analyzed intraoperative pelvic motion using a novel navigation device used to assist surgeons with cup position, leg length, and offset during THA...
May 4, 2017: Journal of Arthroplasty
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