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Lewinnek Safe Zone References are Frequently Misquoted
Aonnicha Burapachaisri1, Ameer Elbuluk2, Edem Abotsi1
1Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.
Arthroplasty Today
|December 10, 2020
Summary
Only 11% of studies correctly reference the Lewinnek safe zone for total hip arthroplasty (THA). This inconsistency in defining THA component orientation may impact implant stability and dislocation rates.
Area of Science:
- Orthopedic Surgery
- Biomechanical Engineering
Background:
- Optimal acetabular component orientation is crucial for total hip arthroplasty (THA) implant stability.
- The definition of the 'safe zone' for THA component placement has been debated.
- Previous reviews have not assessed the consistency of referencing the Lewinnek safe zone definition.
Purpose of the Study:
- To evaluate the consistency of referencing the Lewinnek safe zone definition in the THA literature.
- To determine the frequency of correct citation of the Lewinnek safe zone in published studies.
Main Methods:
- A systematic literature search was conducted in the PubMed database from 1978 to 2019.
- Included articles focused on total hip arthroplasty and mentioned 'Lewinnek' and 'safe zone'.
- Exclusion criteria included abstract-only, non-English, unrelated topics, and articles lacking full content.
Main Results:
- Out of 147 included articles, only 11% correctly cited the Lewinnek definition.
- Measurement positions and reference planes were inconsistently reported across studies.
- Computed tomography was used in 23% of studies for measurements, differing from other methods.
Conclusions:
- A significant majority of studies (89%) do not consistently apply the Lewinnek safe zone definition in THA discussions.
- Inconsistent application of the safe zone definition may affect the interpretation of THA implant stability and dislocation rates.
- Further research is needed to establish consistent terminology and application of the safe zone in THA literature.
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