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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Accuracy of acetabular component position in hip arthroplasty
Robert L Barrack1, Jeffrey A Krempec, John C Clohisy
1Department of Orthopaedic Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. E-mail address for R.L. Barrack: barrackr@wustl.edu.
The Journal of Bone and Joint Surgery. American Volume
|October 4, 2013
Summary
Acetabular component malposition in hip arthroplasty is more likely with lower-volume surgeons and higher body mass index. These factors increase the risk of poor surgical outcomes and revision surgery.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Research
- Biomechanical Engineering
Background:
- Acetabular component malposition is a known risk factor for increased bearing surface wear and instability after hip replacement surgery.
- Optimal component positioning is crucial for the long-term success of total hip arthroplasty (THA) and surface replacement arthroplasty (SRA).
Purpose of the Study:
- To determine the frequency of acetabular component placement within a defined target range for both THA and SRA.
- To identify surgeon and patient-related factors associated with acetabular component malposition.
Main Methods:
- Postoperative radiographs of 1549 THAs and 263 SRAs (2004-2009) were analyzed using the Martell Hip Analysis Suite.
- Acetabular abduction and anteversion angles were measured and compared against institution-defined target ranges.
- Statistical analysis was performed to assess the impact of surgeon volume, body mass index, and other patient/surgical factors on component positioning.
Main Results:
- Using the study's target ranges, 88% of THAs and 84% of SRAs achieved correct abduction and anteversion simultaneously.
- When using previously published target ranges, only 38% of THAs and 65% of SRAs met both abduction and anteversion targets.
- Low-volume surgeons were 2.16 times more likely to miss target component position (p = 0.002), and higher BMI increased the odds of malposition.
Conclusions:
- Lower surgeon volume and higher body mass index are significant risk factors for acetabular component malposition in hip arthroplasty.
- Factors such as minimally invasive approaches, diagnosis, surgical experience, femoral head size, and patient age did not significantly impact component placement.
