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The Transverse Acetabular Ligament as an Intraoperative Guide to Cup Abduction
Willem B Hiddema1, Johan F van der Merwe1, Werner van der Merwe2
1Department of Orthopedic Surgery, University of the Free State, Universitas Academic Hospital, Bloemfontein, South Africa.
The Journal of Arthroplasty
|February 22, 2016
Summary
This study explored using the transverse acetabular ligament (TAL) to guide acetabular cup placement in total hip arthroplasty. Optimal cup inclination was achieved when the cup
Area of Science:
- Orthopedic Surgery
- Biomechanical Engineering
- Anatomy
Background:
- Optimal acetabular cup placement is crucial for total hip arthroplasty (THA) success.
- Malpositioned cups can lead to complications like dislocation, impingement, loosening, and wear.
- The transverse acetabular ligament (TAL) is investigated as a potential landmark for guiding cup placement.
Purpose of the Study:
- To evaluate the efficacy of the transverse acetabular ligament (TAL) as a guide for acetabular cup inclination in primary total hip arthroplasty.
- To determine acceptable cup positioning relative to the TAL.
Main Methods:
- A descriptive cadaveric study involving 16 hips from 9 individuals.
- A computer navigation system was used to measure acetabular component inclination and version.
- Measurements were taken with the cup's lower edge positioned flush, 5 mm proximal, and 5 mm distal to the TAL's free border.
Main Results:
- Median inclination angles were 44°, 30°, and 64° for positions flush with, 5 mm proximal to, and 5 mm distal to the TAL, respectively.
- The median anteversion angle across all positions was 19°.
- Acceptable cup inclination was observed when the lower cup edge was flush or within 5 mm proximal to the TAL.
Conclusions:
- The transverse acetabular ligament (TAL) can serve as a reliable landmark for guiding acetabular cup inclination during THA.
- Positioning the cup's lower edge flush or up to 5 mm proximal to the TAL ensures acceptable inclination.
- This method may help improve surgical accuracy and reduce complications associated with poor cup placement.
