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The transverse pelvic plane: a new and practical reference frame for hip arthroplasty
W Dandachli1, R Richards, V Sauret
1University College London, UK. wdandachli@sky.com
Summary
Surgeons can use the transverse pelvic plane (TPP) for acetabular orientation during hip arthroplasty in the lateral position. This new method is as reliable as the anterior pelvic plane (APP) and may improve surgical accuracy.
Area of Science:
- Orthopedic surgery
- Surgical navigation
- Anatomy
Background:
- Acetabular orientation is critical for successful hip arthroplasty.
- Current methods using the anterior pelvic plane (APP) are challenging in the lateral position due to inaccessibility of the anterior superior iliac spine (ASIS) on the unaffected side.
Purpose of the Study:
- To introduce and validate the transverse pelvic plane (TPP) as a reliable alternative for acetabular orientation in hip arthroplasty.
- To compare the reliability of the TPP with the APP in determining acetabular anteversion and inclination.
Main Methods:
- A computed tomography (CT)-based study was conducted.
- The TPP was defined using the posterior superior iliac spines and the ASIS of the affected side.
- Acetabular cup orientation (anteversion and inclination) was measured and compared between the TPP and APP.
Main Results:
- The transverse pelvic plane (TPP) demonstrated reliability comparable to the anterior pelvic plane (APP) for acetabular orientation.
- Significant inter-patient variations in acetabular measurements were observed.
- The relationship between these measurements and the established "safe zone" for cup placement was analyzed.
Conclusions:
- The transverse pelvic plane (TPP) is a viable and reliable alternative for acetabular orientation in hip arthroplasty, particularly in the lateral position.
- Adoption of the TPP may lead to reduced operating times and enhanced accuracy in computer-assisted hip arthroplasty.
- Surgeons performing hip arthroplasty in the lateral position should consider utilizing the TPP.
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