Preoperative fluoroscopic imaging reduces variability of acetabular component positioning

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Biomechanical Analysis

Background:

• Acetabular component malpositioning is a frequent complication in total hip arthroplasty (THA).
• Preoperative pelvic tilt errors are a significant contributing factor to acetabular malpositioning.
• Accurate patient positioning is crucial for optimal THA outcomes.

Purpose of the Study:

• To quantify preoperative pelvic tilt errors in patients undergoing THA.
• To introduce a novel technique for correcting pelvic tilt errors using fluoroscopic imaging.
• To assess the efficacy of this technique in reducing acetabular component malpositioning.

Main Methods:

• Evaluation of pelvic tilt in 249 hips using fluoroscopic imaging in the lateral decubitus position.
• Measurement of pelvic tilt errors in coronal, transverse, and sagittal planes.
• Implementation of a technique involving operating table repositioning guided by fluoroscopy to correct pelvic tilt.

Main Results:

• Mean absolute pelvic tilt errors were 2.94° (coronal), 2.49° (transverse), and 5.92° (sagittal).
• The described technique effectively corrected preoperative pelvic tilt errors.
• This method reduced the incidence of acetabular component malpositioning.

Conclusions:

• Preoperative pelvic tilt errors are prevalent and impact acetabular component placement in THA.
• A novel, time-efficient fluoroscopy-guided technique can correct these errors without navigation.
• This approach offers a practical solution to improve acetabular component positioning and potentially THA success rates.