Correcting pelvic obliquity in the lateral position to improve acetabular component orientation during total hip arthroplasty.

BACKGROUND: The acetabular component orientation during total hip arthroplasty (THA) impacts future hip function and early revision. Correcting pelvic obliquity may improve outcomes.

OBJECTIVE: To correct pelvic obliquity in the lateral position by applying a gradienter and plumb during THA using fluoroscopy.

METHODS: Fifty patients undergoing THA were randomized and divided into 2 groups. In controls, acetabular components were placed using traditional methods. In experimental patients, acetabular components were placed after correcting pelvic obliquity. We measured pelvic obliquity and recorded intra-operative and post-operative abduction angles, comparing abduction angle bias between post-operative measurements and intra-operation estimations.

RESULTS: Before correction, the average pelvic obliquity was -1.647∘± 4.512∘ in experimental patients. The average abduction angle in experimental patients was 42.685∘± 3.355∘ postoperatively, differing by 1.962∘± 1.515∘ from intra-operative estimates, while in control patients, it was 44.534∘± 4.844∘ postoperatively, differing by 4.244∘± 3.042∘ from intra-operative estimates. The bias of the abduction angle was much greater in control than in experimental patients (P< 0.05).

CONCLUSION: The pelvic obliquity in the lateral position affects surgeon judgment during THA. By correcting pelvic obliquity with a gradienter and plumb, the abduction angle bias can be reduced.