Related Experiment Video
Updated: Mar 25, 2026
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
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.
Background:
The success of a total hip arthroplasty relies on optimal acetabular cup placement to ensure mating of the femoral head and acetabular cup throughout all positions of the hip joint. Poor cup placement is associated with dislocation, impingement, microseparation, component loosening, and accelerated wear due to rim loading. This study examined a novel method of using the transverse acetabular ligament (TAL) to guide cup inclination during primary total hip arthroplasty.
Methods:
A descriptive study using 16 hips from 9 cadavers. A computer navigation system measured inclination and version of the acetabular component in 3 positions with the lower edge of cup: (1) flush with, (2) 5 mm proximal to, and (3) 5 mm distal to free border of the TAL.
Results:
The median inclination angles were 44° in position (1), 30° in position (2), and 64° in position (3). The median anteversion angle for all positions was 19°.
Conclusion:
Cup inclination was acceptable when the lower edge of the cup was flush or within 5 mm proximal to the TAL.
