Anteversion of the acetabular component aligned with the transverse acetabular ligament in total hip arthroplasty

In total hip arthroplasty (THA), accurately positioning the cup is crucial for achieving an adequate postoperative range of motion and stability. For 47 THA cases in which the inferomedial rim of the cup had been positioned parallel to the transverse acetabular ligament, we retrospectively performed the measurements of the radiographic cup anteversion angle relative to the anterior pelvic plane using 3-dimensional reconstruction computed tomography. The mean anteversion angle was 21.2°, with no significant difference detected in mean cup anteversion between the dysplastic hip group (15 hips) and the control group (15 hips). We suggest that the transverse acetabular ligament is a practical anatomical landmark for determining cup anteversion in THA for both dysplastic and nondysplastic hip cases.