Spinopelvic mobility and acetabular component position for total hip arthroplasty
M Stefl1, W Lundergan1, N Heckmann1
1Keck Medical Centre of USC, 1520 San Pablo Street, Suite 2000, Los Angeles, CA 90033, USA.
The Bone & Joint Journal
|January 3, 2017
Summary
Posterior pelvic tilt aids acetabular opening. Correcting acetabular component position in total hip arthroplasty can prevent impingement, even with spinal imbalance.
Area of Science:
- Orthopedic surgery
- Radiographic analysis
- Biomechanical engineering
Background:
- Pelvic tilt during sitting creates a natural acetabular opening.
- Understanding the interplay between spinal mobility and acetabular component placement is crucial for surgical outcomes.
Purpose of the Study:
- To investigate the relationship between skeletal mobility and sagittal acetabular component position after hip surgery.
- To assess the risk of impingement based on implant positioning relative to spinal alignment.
Main Methods:
- Radiographic study of 160 hips (151 patients) using lateral spinopelvic hip radiographs.
- Assessed intra-operative acetabular component position based on pre-operative spinal mobility.
- Used ante-inclination and sacral acetabular angles as surrogates for impingement risk.
Main Results:
- 83.1% of hips had normal post-operative ante-inclination and sacral acetabular angles.
- Only 4.4% of hips showed pathological imbalance (fused hips).
- Corrective acetabular component positioning successfully addressed pre-operative spinal imbalance in 23 of 24 hips.
Conclusions:
- 90% of hips were safe from impingement post-operatively.
- Patients with spinal fusion face the highest risk; however, correctable spinal imbalance can be managed with proper acetabular component positioning.
- This study provides crucial guidelines for total hip arthroplasty by correlating acetabular component position with spinal pelvic mobility.
Keywords:
Arthroplasty
