776 results match your criteria inclination cup


Direct anterior approach vs. SuperPATH vs. conventional approaches in total hip replacement: a network meta-analysis of randomized controlled trials.

Orthop Traumatol Surg Res 2021 Sep 15:103058. Epub 2021 Sep 15.

Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Friedrich Schiller University, Am Klinikum 1, 07747 Jena, Germany.

Background: Two minimally invasive approaches showed some advantages in outcomes compared to conventional approaches (CAs) - the direct anterior approach (DAA) and the supercapsular percutaneously assisted approach in THA (SuperPATH). To the best of our knowledge, DAA and SuperPATH have never been compared in clinical studies before. Therefore, we conducted a systematic review and network meta-analysis of randomized controlled trials comparing short-term outcomes of DAA, SuperPATH and CAs in total hip joint arthroplasty (THA), using CAs as common comparator. Read More

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September 2021

Robotic-Arm Assisted versus Manual Total Hip Arthroplasty: Systematic Review and Meta-analysis of Radiographic Accuracy.

Int J Med Robot 2021 Sep 16:e2332. Epub 2021 Sep 16.

Department of Orthopaedic Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.

Background: We systematically reviewed the radiological outcomes of studies comparing robotic-assisted (RA-THA) and manual total hip arthroplasty (mTHA) .

Methods: The PubMed, Embase, and Cochrane databases were queried from 1994-2021 for articles comparing radiographic outcomes between RA-THA and mTHA cohorts. A meta-analysis was conducted whenever sufficient data was present for common outcomes. Read More

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September 2021

Consideration of pelvic tilt at the time of preoperative planning improves standing acetabular position after robotic-arm assisted total hip arthroplasty.

Hip Int 2021 Sep 12:11207000211038670. Epub 2021 Sep 12.

Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA.

Introduction: Approximately half of dislocating total hip arthroplasties (THAs) demonstrate acetabular component position within traditional safe zones. It is unclear if postoperative functional acetabular position can be reliably improved by considering preoperative pelvic tilt. We investigated whether standing cup position targets could be more accurately achieved by considering preoperative standing pelvic tilt in addition to bone landmarks when planning for robot-assisted THA. Read More

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September 2021

A Modeling Study of a Patient-specific Safe Zone for THA: Calculation, Validation, and Key Factors Based on Standing and Sitting Sagittal Pelvic Tilt.

Clin Orthop Relat Res 2021 Aug 10. Epub 2021 Aug 10.

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China.

Background: Lumbar-pelvic stiffness and sagittal imbalance have been reported to increase the risk of dislocation and wear after THA. One potential way to approach this concern is by identifying patient-specific safe zones for THA components based on the standing and sitting sagittal pelvic tilt. However, there is no algorithm to integrate the standing and sitting pelvic tilt into the surgical plan of component orientations. Read More

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Low dislocation rates with the use of patient specific "Safe zones" in total hip arthroplasty.

J Orthop 2021 Sep-Oct;27:41-48. Epub 2021 Aug 21.

Hospital for Special Surgery, Department of Orthopedic Surgery, Adult Reconstruction and Joint Replacement, New York, NY 10021, USA.

Introduction: The purpose of this study was to compare patient-specific acetabular cup target orientation using functional simulation to the Lewinnek Safe Zone (LSZ) and determine associated rates of postoperative dislocation.

Methods: A retrospective review of 1500 consecutive primary THAs was performed. Inclination, anteversion, pelvic tilt, pelvic incidence, lumbar flexion, and dislocation rates were recorded. Read More

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Can we trust combined anteversion and Lewinnek safe zone to avoid hip prosthesis dislocation?

J Clin Orthop Trauma 2021 Oct 8;21:101562. Epub 2021 Aug 8.

Hip Unit, Department of Orthopedic Surgery, University Hospital of Vall d'Hebron, Universitat Autónoma de Barcelona, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.

Introduction: Dislocation is one of the most common complications after primary total hip arthroplasty (THA). Combined anteversion (CA) is currently considered one of the most important measures of stability for THA. Thus, the aim of this study is to determine the association between a correct CA after THA and hip prosthesis dislocation, and to analyze the reliability of the Lewinnek safe zone parameters. Read More

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October 2021

Preoperative radiographs to predict component malposition in direct anterior approach total hip arthroplasty.

Hip Int 2021 Aug 23:11207000211037596. Epub 2021 Aug 23.

Orthopaedics Department, Royal Hobart Hospital, Hobart, TAS, Australia.

Introduction: There is conflicting evidence as to whether or not patients undergoing total hip arthroplasty (THA) via the direct anterior approach (DAA) have increased risk of component malposition. The aim of this study was to investigate whether specific preoperative radiographic features were predictive of postoperative component malposition in DAA THA.

Patients And Methods: We examined 204 THA operations performed for osteoarthritis via the DAA at a single institution. Read More

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Accuracy of acetabular cup placement positively correlates with level of training.

Int Orthop 2021 Aug 18. Epub 2021 Aug 18.

Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.

Background: Accurate acetabular component placement may reduce the risk of complication after total hip arthroplasty (THA). While surgeon experience and volume may reduce outliers, little is known how cup positioning accuracy and consistency relates to level of training (resident, fellow, attending) and whether trainee level impacts the magnitude and direction of cup placement errors.

Methods: Ninety patients undergoing posterolateral computer-assisted navigation THA were included for analysis. Read More

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Accuracy and reproducibility of visual estimation of the acetabular cup positioning in total hip arthroplasty on plain radiographs by orthopaedic surgeons.

J Perioper Pract 2021 Aug 16:17504589211026074. Epub 2021 Aug 16.

Department of Trauma and Orthopaedics, Princess Royal University Hospital, London, UK.

Objectives: To examine whether trauma and orthopaedic surgeons could visually assess the anteversion and inclination of a total hip replacement acetabular component from standard anteroposterior radiograph and anteversion on a standard lateral radiograph with accuracy or reproducibility.Main outcome measurement: The main outcome was accuracy of visual estimations of angles. The secondary outcome was whether these estimations were reproducible though intra-observer variability. Read More

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No benefits of minimally invasive total hip arthroplasty via Watson-Jones approach: A retrospective cohort study.

Surgeon 2021 Aug 10. Epub 2021 Aug 10.

Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081, Baronissi, (SA), Italy; School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, England, UK; Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, England, UK. Electronic address:

Introduction: There is controversy about the role of minimally invasive surgery (MIS) for total hip arthroplasty (THA). The present study aimed to investigate whether a MIS approach has a positive impact on the outcome of THA via the Watson-Jones anterolateral approach. Clinical scores and radiological findings of minimally and standard invasive exposures were evaluated and compared. Read More

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Intraoperative measurement of acetabular component position using imageless navigation during revision total hip arthroplasty.

Can J Surg 2021 Aug 1;64(4):E442-E448. Epub 2021 Aug 1.

From the Division of Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ont.

Background: Acetabular component malposition is a major cause of dislocation following total hip arthroplasty (THA). Intellijoint HIP is an imageless navigation tool that has been shown to provide accurate intraoperative measurement of cup position during primary THA without substantially increasing operative time. However, its accuracy in revision THA has not been evaluated. Read More

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Limited effects on patient outcomes of conjoint tendon release in anterolateral muscle-sparing total hip arthroplasty.

J Orthop Surg Res 2021 Aug 10;16(1):485. Epub 2021 Aug 10.

Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.

Background: The anterolateral muscle-sparing total hip arthroplasty (THA) in the supine position is advantageous owing to the very low-dislocation rate and excellent leg length discrepancy control. However, femur exposure is challenging. Although the conjoined external rotators tendon (CERT) release is effective in improving femoral access, the effects on clinical outcomes remain unclear. Read More

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Restoring hip biomechanics during the learning curve of a novice surgeon: Direct anterior approach vs posterior approach.

J Orthop 2021 Jul-Aug;26:72-78. Epub 2021 Jul 13.

Hip Surgery Unit, Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona Departament de Cirurgia, Barcelona, Spain.

Introduction: It remains controversial whether the direct anterior approach (DAA) or the posterior approach (PA) allows better restoration of hip biomechanics after total hip arthroplasty (THA). Besides, it is not certain which approach is best for a novice surgeon to avoid implant malposition, neither during the learning curve nor once the curve plateau has been reached.

Methods: We performed a retrospective cohort study of THAs operated on between 2014 and 2019 by a single novice surgeon (DAA, n = 187; PA, n = 184). Read More

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Robotic-Assisted Total Hip Arthroplasty in Patients Who Have Developmental Hip Dysplasia.

Surg Technol Int 2021 07 26;39. Epub 2021 Jul 26.

Department of Orthopedic Surgery, Northwell Health, Lenox Hill Hospital, New York, New York.

Introduction: Total hip arthroplasty (THA) in the setting of developmental dysplasia of the hip (DDH) presents more inherent complexities than routine primary THA for osteoarthritis. These include acetabular bone deficiency, limb length discrepancy (LLD), and abnormal femoral anteversion. Three-dimensional planning and robot-assisted (RA) bone preparation may simplify these complex procedures and make them more reproducible. Read More

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Proposal of accurate cup placement procedure during total hip arthroplasty based on pelvic tilt discrepancies in the lateral position.

Sci Rep 2021 Jul 6;11(1):13870. Epub 2021 Jul 6.

Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.

By combining the anatomical-pelvic-plane (APP) positioner with a newly improved navigation system during total hip arthroplasty (THA), it is theoretically possible to determine cup orientation based on the APP while tracking pelvic movement. The purpose of this study was to determine the navigation accuracy and whether the error is related to the pelvic position fixed by the positioner. Fifty hips that underwent primary THA between 2018 and 2020 were analysed. Read More

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Assessing the performance and learning curve of orthopaedic surgical trainees in primary total hip arthroplasty.

Ann R Coll Surg Engl 2021 Jul;103(7):514-519

Nuffield Orthopaedic Centre, Oxford, UK.

Introduction: The aims of this study were threefold: first, to review the surgical performance of trainees in our departments by reviewing postoperative radiographs and operative times; second, to investigate the effect of supervision and assistant grade on postoperative radiographs and operative times; and third, to monitor trainees over a 6-month period looking for changes in postoperative radiograph appearances and operative times to assess whether these parameters reflect a trainee's learning curve.

Methods: A retrospective evaluation of a continuous series of primary hip arthroplasty procedures performed by 12 trainee orthopaedic surgeons (StR) during their arthroplasty rotation. In total, 348 primary total hip replacement (pTHR) operations were performed by StRs. Read More

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Well-Placed Acetabular Component Oriented Outside the Safe Zone During Weight-Bearing Daily Activities.

Front Bioeng Biotechnol 2021 10;9:664907. Epub 2021 Jun 10.

Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.

A comprehensive and thorough understanding of functional acetabular component orientation is essential for optimizing the clinical outcome after total hip arthroplasty (THA). This study aimed to quantify the functional acetabular anteversion and inclination of unilateral THA patients during walking and static standing and to determine whether the functional acetabular orientation falls within the Lewinnek safe zone. Seventeen patients with unilateral THA received a CT scan and dual fluoroscopic imaging during level walking and static standing to evaluate hip kinematics. Read More

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Evaluating Alternate Registration Planes for Imageless, Computer-Assisted Navigation During Total Hip Arthroplasty.

J Arthroplasty 2021 Jun 2. Epub 2021 Jun 2.

Department of Clinical Research, Intellijoint Surgical, Kitchener, Ontario, Canada.

Background: Imageless computer navigation improves component placement accuracy in total hip arthroplasty (THA), but variations in the registration process are known to impact final accuracy measurements. We sought to evaluate the registration accuracy of an imageless navigation device during THA performed in the lateral decubitus position.

Methods: A prospective, observational study of 94 patients undergoing a primary THA with imageless navigation assistance was conducted. Read More

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Inter and intra-observer errors for postoperative total hip radiographic assessment using computer aided design.

Acta Orthop Belg 2021 Mar;87(1):65-71

Plain radiographic assessment of primary total hip arthroplasty following surgery remains to be the commonest radiological assessment. The current paper, studies the accuracy and concordance between observers reviewing these radiographs. A prospective radiographic and medical note review of ten patients who underwent total hip replacement for primary osteoarthritis, with a mean age of 69 years. Read More

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MRI Assessment of Muscle Damage After the Posterolateral Versus Direct Anterior Approach for THA (Polada Trial). A Randomized Controlled Trial.

J Arthroplasty 2021 Sep 15;36(9):3248-3258.e1. Epub 2021 May 15.

Department of Orthopaedic Surgery, Martini Hospital Groningen, the Netherlands.

Background: There is controversy in literature whether the direct anterior approach (DAA) results in less muscle damage compared with the posterolateral approach (PLA) for total hip arthroplasty. The aim of this randomized controlled trial was to assess muscle damage between these two approaches.

Methods: Forty-six patients were included. Read More

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September 2021

Comparison of Cup Setting Angle Accuracy between Computed Tomography-Based and Computed Tomography-Free Navigation in the Same Patients with Crowe's Classification I or II Hip Dysplasia.

Clin Orthop Surg 2021 Jun 12;13(2):144-151. Epub 2021 Apr 12.

Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Yufu, Japan.

Backgroud: In total hip arthroplasty, the cup setting angle may affect the postoperative results. In recent years, both computed tomography-based navigation and computed tomography-free (imageless) navigation have been reported to produce high accuracy in cup installation; however, no direct comparison between these two methods has been performed. The present study aimed to directly compare the cup installation angle accuracy between computed tomography-based navigation and computed tomography-free navigation in patients with Crowe's classification stage I or II dysplastic osteoarthritis and to examine the factors affecting the cup installation accuracy. Read More

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Kinematic pelvic tilt during gait alters functional cup position in total hip arthroplasty.

J Orthop Res 2021 May 31. Epub 2021 May 31.

Department of Orthopaedic Surgery, Orthopaedic Surgery, Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, New York, USA.

Static pelvic tilt impacts functional cup position in total hip arthroplasty (THA). In the current study we investigated the effect of kinematic pelvic changes on cup position. In the course of a prospective controlled trial postoperative 3D-computed tomography (CT) and gait analysis before and 6 and 12 months after THA were obtained in 60 patients. Read More

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The influence of sagittal pelvic malrotation on transverse acetabular ligament guided cup orientation: a retrospective cohort study.

BMC Musculoskelet Disord 2021 May 28;22(1):495. Epub 2021 May 28.

Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37# Guoxue Rd, 610041, Chengdu, China.

Background: Total hip arthroplasty (THA) candidates frequently present pelvic malrotation. The aim of this study is to analyze how pelvic malrotation influence transverse acetabular ligament (TAL) guided cup orientation and investigate whether pelvic malrotation produce different clinical outcomes after THA.

Methods: We retrospectively reviewed a consecutive series of THA patients (144 hips) who use TAL as a guidance for cup positioning from March 2017 to January 2020. Read More

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Computational modelling of hip resurfacing arthroplasty investigating the effect of femoral version on hip biomechanics.

PLoS One 2021 27;16(5):e0252435. Epub 2021 May 27.

Department of Surgery, Section of Orthopaedic Surgery, University of Calgary, Calgary, Canada.

Aim: How reduced femoral neck anteversion alters the distribution of pressure and contact area in Hip Resurfacing Arthroplasty (HRA) remains unclear. The purpose of this study was to quantitatively describe the biomechanical implication of different femoral neck version angles on HRA using a finite element analysis.

Materials And Methods: A total of sixty models were constructed to assess the effect of different femoral neck version angles on three different functional loads: 0°of hip flexion, 45°of hip flexion, and 90° of hip flexion. Read More

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Pelvic tilt impacts cup orientation on CT: how accurate is the gold standard?

Acta Radiol 2021 May 13:2841851211009466. Epub 2021 May 13.

Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany.

Background: Computed tomography (CT) is the gold standard for the accurate measurement of cup inclination and anteversion in total hip arthroplasty (THA). However, functional cup position strongly depends on the tilt of the pelvis and thus pelvic tilt in the supine position on the CT table harbors the risk of misinterpretation.

Purpose: To evaluate the influence of pelvic tilt on cup measurements in postoperative CT scans. Read More

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Comparison between freehand technique and computed tomography-based navigation in acetabular cup placement through direct anterior approach for total hip arthroplasty.

Arch Orthop Trauma Surg 2021 Apr 30. Epub 2021 Apr 30.

Department of Orthopaedic Surgery, Daini Osaka Police Hospital, 2-6-40 Karasugatsuji, Tennouji-ku, Osaka, 543-8922, Japan.

Introduction: In total hip arthroplasty (THA), improper cup orientation can result in dislocation, early excessive polyethylene wear, and pain following THA. The supine position during THA provides a more reproducible functional pelvic position than the lateral decubitus position and may allow freehand cup placement as reliable as that obtained by computer navigation. The purpose of this study was to investigate the accuracy of freehand cup placement through a supine direct anterior approach (DAA) compared with computed tomography (CT)-based navigation. Read More

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Comparison of the accuracy of the cup position and orientation in total hip arthroplasty for osteoarthritis secondary to developmental dysplasia of the hip between the Mako robotic arm-assisted system and computed tomography-based navigation.

Int Orthop 2021 07 20;45(7):1719-1725. Epub 2021 Apr 20.

Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

Purpose: We investigated the accuracy of the acetabular cup position and orientation in robotic-assisted total hip arthroplasty (rTHA) compared to navigated THA (nTHA) using computed tomography (CT) for patients with osteoarthritis secondary to developmental dysplasia of the hip (DDH).

Methods: We studied 31 hips of 28 patients who underwent rTHA and 119 hips of 112 patients who underwent nTHA with the same target cup orientation. After propensity score matching, each group comprised 29 hips. Read More

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Accuracy of cup position following robot-assisted total hip arthroplasty may be associated with surgical approach and pelvic tilt.

Sci Rep 2021 Apr 7;11(1):7578. Epub 2021 Apr 7.

Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.

This study aimed to investigate the accuracy of cup placement and determine the predictive risk factors for inaccurate cup positioning in robot-assisted total hip arthroplasty (THA). We retrospectively analyzed 115 patients who underwent robot-assisted THA between August 2018 and November 2019. Acetabular cup alignment and three-dimensional (3D) position were measured using pre- or postoperative computed tomography (CT) data. Read More

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Pseudotumors in Small-Head Metal-on-Metal Total Hip Arthroplasties at a Minimum Follow-Up of 20 Years.

J Arthroplasty 2021 08 10;36(8):2871-2877. Epub 2021 Mar 10.

Division of Orthopedics, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria.

Background: Metal-on-metal (MOM) surfaces in total hip arthroplasty (THA) have been used widely. Serum cobalt and chromium levels have been the standard investigation for follow-up examinations, but magnetic resonance imaging (MRI) with metal artifact reducing sequences has shown good results in detecting pseudotumors. The aim of this study is to survey a significant correlation among MRI findings, serum metal levels, and clinical scores in patients with small-head MOM implants and if serum cobalt and chromium levels are sufficient in detecting patients with pseudotumors in the long-term follow-up. Read More

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Endoscopic Tenotomy for Iliopsoas Tendinopathy Following Total Hip Arthroplasty Can Relieve Pain Regardless of Acetabular Cup Overhang or Anteversion.

Arthroscopy 2021 09 31;37(9):2820-2829. Epub 2021 Mar 31.

Hip Surgery Unit, Hospital Israelita Albert Einstein, São Paulo - SP, Brazil; Lyon Ortho Clinic, Lyon, France.

Purpose: To report outcomes of endoscopic iliopsoas tenotomy (EIT) in patients with iliopsoas tendinopathy following total hip arthroplasty (THA) and determine whether improvements in clinical scores are associated with acetabular cup anteversion measured on plain radiographs or overhang measured using established and alternative computed tomography (CT)-based methods.

Methods: We evaluated patients who underwent EIT for iliopsoas tendinopathy after THA (2014-2017), performed between the lesser trochanter and psoas valley. Indications were groin pain during active hip flexion, exclusion of other complications, and no pain relief after 6 months of conservative treatment. Read More

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September 2021