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Related Concept Videos

Anatomical Positions01:11

Anatomical Positions

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In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
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Consider a man with a mass of 70 kg seated in a chair connected to a pin support through a member BC. If the man maintains an upright position, the task is to determine the horizontal and vertical reactions of the chair on the man when the member makes a 45° angle with the horizontal. At this moment, the man has a speed of 5 m/s, increasing at a rate of 1 m/s².
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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Predictability of Acetabular Component Angular Change with Postural Shift from Standing to Sitting Position.

Vaibhav Kanawade1, Lawrence D Dorr1, Zhinian Wan1

  • 1Orthopedic Department, Keck Medical Center of USC, 1520 San Pablo Street, Suite 2000, Los Angeles, CA 90033. E-mail address for L.D. Dorr: patriciajpaul@yahoo.com.

The Journal of Bone and Joint Surgery. American Volume
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Summary

Changes in acetabular cup angles during sitting can cause hip instability and wear after total hip replacement. Pelvic tilt stiffness can predict these angle changes, allowing for surgical adjustments to improve outcomes.

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Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering
  • Radiology

Background:

  • Acetabular component angles in total hip replacement (THR) are dynamic and change with posture.
  • These postural changes can significantly impact THR stability and lead to wear.
  • Understanding and predicting these angle shifts is crucial for optimizing surgical outcomes.

Purpose of the Study:

  • To correlate intraoperative acetabular cup angles (inclination and anteversion) with angle changes during postural shifts from standing to sitting.
  • To determine if these postoperative angle changes are predictable based on preoperative measurements.

Main Methods:

  • Sagittal spinopelvic radiographs were obtained from 85 patients in standing and sitting positions, pre- and post-THR.
  • Pelvic tilt and spinosacral tilt were measured to classify spinal/pelvic stiffness.
  • A phantom model was used to correlate intraoperative angles with sagittal cup position changes (ante-inclination).

Main Results:

  • Normal pelvic stiffness showed 20°-35° posterior tilt when moving from standing to sitting.
  • Acetabular cup ante-inclination increased significantly from standing (29.6°) to sitting (54.6°).
  • Stiffer pelves exhibited less tilt, and the phantom model demonstrated that ante-inclination is predictable using preoperative pelvic tilt changes.

Conclusions:

  • Postural changes, particularly sitting, lead to a more vertical acetabular cup (ante-inclination), increasing risks of hip instability and edge-loading wear.
  • Patients with supine cup inclination ≥50°, anteversion ≥25°, or hypermobile pelves are at higher risk.
  • The pelvic spatial position during postural changes is a key factor influencing postoperative consequences of acetabular cup placement.