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Natural acetabular orientation in arthritic hips.

S T Goudie¹, A H Deakin¹, K Deep¹

¹Golden Jubilee National Hospital, Agamemnon Street, Clydebank, Glasgow, G81 4DY, UK.

Bone & Joint Research

|January 29, 2015

Summary

The natural orientation of the acetabulum in arthritic hips varies between men and women. In most cases, this natural orientation falls outside the recommended safe zone for total hip arthroplasty component placement.

Keywords:

Acetabulum; Orientation; Arthritis; Computer Navigation; Inclination; anteversion Total hip arthroplasty; THA

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Published on: February 27, 2018

Area of Science:

Orthopedic surgery
Biomechanical engineering
Radiology

Background:

Acetabular component orientation is critical for successful total hip arthroplasty (THA) outcomes.
The natural orientation of the arthritic acetabulum is frequently used as a reference for intra-operative component positioning.
Understanding the typical orientation of the arthritic acetabulum is essential for optimizing surgical technique.

Purpose of the Study:

To determine the acetabular inclination and anteversion in patients with arthritic hips undergoing THA.
To provide detailed orientation data for the natural arthritic acetabulum.

Main Methods:

Acetabular inclination and anteversion were measured in 65 patients with primary osteoarthritis requiring THA.
A computer navigation system was utilized for precise orientation measurements.
Patient demographics included 29 men and 36 women, with a mean age of 68 years.

Main Results:

Mean acetabular inclination was 50.5° (SD 7.8) in men and 52.1° (SD 6.7) in women.
Mean acetabular anteversion was 8.3° (SD 8.7) in men and 14.4° (SD 11.6) in women.
A significant difference in anteversion was observed between men and women (p = 0.022).
In 75% of hips, the natural orientation was outside the established safe zone (Lewinnek et al.: anteversion 15° ± 10°, inclination 40° ± 10°).

Conclusions:

Awareness of gender-specific differences in acetabular anteversion is important for THA.
The natural orientation of the acetabulum in a significant majority of arthritic hips lies outside commonly accepted safe zones.
These findings highlight the need for careful consideration of native acetabular orientation during THA component placement to avoid deviations from optimal positioning.