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In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
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Hemispheric cups do not reproduce acetabular rim morphology
Eric Vandenbussche1, Mohammed Saffarini, Nicolas Delogé
1Department of Orthopaedic Surgery, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, FR-75908 Paris, France. eric.vdb@egp.ap-hop-paris.fr
Acta Orthopaedica
|July 6, 2007
Summary
Iliopsoas impingement after hip arthroplasty (THA) is common. Adapting prosthetic cup design to individual acetabular anatomy is key to preventing this complication.
Area of Science:
- Orthopedic surgery
- Biomechanical engineering
- Anatomical studies
Background:
- Iliopsoas impingement is a recurring complication after total hip arthroplasty (THA).
- It results from friction between the iliopsoas muscle and a protruding prosthetic acetabular cup.
- Understanding acetabular rim morphology is crucial for prevention strategies.
Purpose of the Study:
- To quantify dimensional variations in acetabular rim profiles, focusing on the iliopubic valley.
- To identify anatomical factors contributing to iliopsoas impingement.
- To inform the design of prosthetic cups for THA to prevent impingement.
Main Methods:
- Analysis of 34 cadaver pelvises using a hip navigation system.
- Morphometric data collection to plot acetabular rim profiles.
- Detailed assessment of the shape and depth of the psoas valley.
Main Results:
- Acetabular rims exhibit an asymmetric profile with three peaks and three troughs.
- The psoas valley is a prominent feature in most analyzed pelvises.
- Psoas valley depth showed weak correlation with acetabular diameter, anteversion, or inclination.
Conclusions:
- Standard hemispheric cups may not adequately address anterior acetabular overlap in certain anatomies without compromising range of motion or stability.
- Adapting acetabular cup design to specific acetabular anatomy is recommended for iliopsoas impingement prevention.
- This may necessitate distinct implant designs for the right and left sides, potentially increasing inventory.
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