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Related Concept Videos

Anatomical Positions01:11

Anatomical Positions

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In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
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Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy
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A New Normative Zone for Acetabular Anteversion Positioning in ASD Patients.

Marc Boutros1, Ayman Assi1,2, Bassel G Diebo3

  • 1Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
|February 28, 2026
PubMed
Summary
This summary is machine-generated.

Patient-specific safe zones for acetabular anteversion can reduce hip dislocation risk in adult spinal deformity patients undergoing total hip arthroplasty. These zones account for spinopelvic variations, improving implant positioning.

Keywords:
Lewinnek zoneacetabular anteversionadult spinal deformitydislocationtotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Spine Surgery

Background:

  • Adult spinal deformity (ASD) patients undergoing total hip arthroplasty (THA) have higher hip dislocation rates compared to those with normal spinal alignment.
  • The traditional Lewinnek safe zone for acetabular implant placement is insufficient for ASD patients due to significant spinopelvic variations like pelvic retroversion.

Purpose of the Study:

  • To define and validate patient-specific normative zones for acetabular anteversion in ASD patients.
  • To develop a method for optimizing acetabular cup placement that accounts for individual spinopelvic alignment and surgical plans, aiming to reduce dislocation risk.

Main Methods:

  • A multicenter retrospective analysis involving 146 ASD patients and 47 asymptomatic controls.
  • Three-dimensional biplanar radiograph reconstructions were used to measure spinopelvic alignment and acetabular orientation.
  • Three distinct normative zones for acetabular anteversion were defined based on pelvic tilt and pelvic incidence, considering different surgical scenarios (no spinal realignment, post-spinal realignment, uncertain plans).

Main Results:

  • Normative Zone 1 (no spinal realignment) and Zone 2 (post-spinal realignment) were delineated using specific regression formulas based on pelvic tilt and incidence.
  • Normative Zone 3, the intersection of Zones 1 and 2, provided a narrower target anteversion range for complex cases.
  • These patient-specific zones enable tailored acetabular cup placement, considering individual spinopelvic parameters.

Conclusions:

  • The study successfully defined patient-specific normative zones for acetabular anteversion, addressing limitations of traditional methods in ASD patients.
  • Implementing these tailored zones has the potential to significantly reduce the risk of hip dislocation in patients with spinal malalignment undergoing THA.
  • This approach offers a clinically significant advancement in optimizing acetabular component positioning for complex orthopedic cases.