Correction of pelvic adduction during total hip arthroplasty reduces variability in radiographic inclination: findings of a randomised controlled trial

C O'Neill, P Magill, Janet Hill, C Patterson, Dennis Molloy, Harinderjit Gill, David Beverland

Research output: Contribution to journalArticle

1 Citation (Scopus)
23 Downloads (Pure)

Abstract

Introduction: The study aims were to identify the incidence of pelvic adduction during total hip arthroplasty (THA) in lateral decubitus and to determine, when aiming for 35° of apparent operative inclination (AOI), which of 3 operating table positions most accurately obtained a target radiographic inclination (RI) of 42°: (1) horizontal; (2) 7° head-down; (3) patient-specific position based on correction of pelvic adduction.

Methods: With patients seated on a levelled theatre table, a ruler incorporating a spirit level was used to draw transverse pelvic lines (TPLs) on the skin overlying the pelvis and sacrum. Subsequently, when positioned in lateral decubitus these lines provided a measure of pelvic adduction. 270 participants were recruited, with 90 randomised to each group for operating table position. In all cases target AOI was 35°, aiming to achieve a target RI of 42°. The primary outcome measure was absolute (unsigned) deviation from the target RI of 42°.

Results: 266/270 patients demonstrated pelvic adduction (overall mean 4.4°, range 0– 9.2°). No patients demonstrated pelvic abduction. There were significant differences in RI between each of the 3 groups. The horizontal table group displayed the highest mean RI. The patient specific table position group achieved the smallest absolute deviation from target RI of 42°.

Discussion: In lateral decubitus, unrecognised pelvic adduction is common and is an important contributor to unexpectedly high RI. The use of preoperative transverse pelvic lines helps identify pelvic adduction and its subsequent correction reduces variability in RI.
Original languageEnglish
Pages (from-to)240-245
Number of pages6
JournalHip International
Volume28
Issue number3
DOIs
Publication statusPublished - 1 May 2018

Fingerprint

Arthroplasty
Hip
Randomized Controlled Trials
Operating Tables
Sacrum
Pelvis
Head
Outcome Assessment (Health Care)
Skin
Incidence

Cite this

Correction of pelvic adduction during total hip arthroplasty reduces variability in radiographic inclination: findings of a randomised controlled trial. / O'Neill, C; Magill, P; Hill, Janet; Patterson, C; Molloy, Dennis; Gill, Harinderjit; Beverland, David.

In: Hip International, Vol. 28, No. 3, 01.05.2018, p. 240-245.

Research output: Contribution to journalArticle

O'Neill, C ; Magill, P ; Hill, Janet ; Patterson, C ; Molloy, Dennis ; Gill, Harinderjit ; Beverland, David. / Correction of pelvic adduction during total hip arthroplasty reduces variability in radiographic inclination: findings of a randomised controlled trial. In: Hip International. 2018 ; Vol. 28, No. 3. pp. 240-245.
@article{afddeda498de41d8b84245598411811e,
title = "Correction of pelvic adduction during total hip arthroplasty reduces variability in radiographic inclination: findings of a randomised controlled trial",
abstract = "Introduction: The study aims were to identify the incidence of pelvic adduction during total hip arthroplasty (THA) in lateral decubitus and to determine, when aiming for 35° of apparent operative inclination (AOI), which of 3 operating table positions most accurately obtained a target radiographic inclination (RI) of 42°: (1) horizontal; (2) 7° head-down; (3) patient-specific position based on correction of pelvic adduction.Methods: With patients seated on a levelled theatre table, a ruler incorporating a spirit level was used to draw transverse pelvic lines (TPLs) on the skin overlying the pelvis and sacrum. Subsequently, when positioned in lateral decubitus these lines provided a measure of pelvic adduction. 270 participants were recruited, with 90 randomised to each group for operating table position. In all cases target AOI was 35°, aiming to achieve a target RI of 42°. The primary outcome measure was absolute (unsigned) deviation from the target RI of 42°. Results: 266/270 patients demonstrated pelvic adduction (overall mean 4.4°, range 0– 9.2°). No patients demonstrated pelvic abduction. There were significant differences in RI between each of the 3 groups. The horizontal table group displayed the highest mean RI. The patient specific table position group achieved the smallest absolute deviation from target RI of 42°.Discussion: In lateral decubitus, unrecognised pelvic adduction is common and is an important contributor to unexpectedly high RI. The use of preoperative transverse pelvic lines helps identify pelvic adduction and its subsequent correction reduces variability in RI.",
author = "C O'Neill and P Magill and Janet Hill and C Patterson and Dennis Molloy and Harinderjit Gill and David Beverland",
year = "2018",
month = "5",
day = "1",
doi = "10.1177/1120700018777480",
language = "English",
volume = "28",
pages = "240--245",
journal = "Hip International",
issn = "1724-6067",
publisher = "Wichtig Publishing",
number = "3",

}

TY - JOUR

T1 - Correction of pelvic adduction during total hip arthroplasty reduces variability in radiographic inclination: findings of a randomised controlled trial

AU - O'Neill, C

AU - Magill, P

AU - Hill, Janet

AU - Patterson, C

AU - Molloy, Dennis

AU - Gill, Harinderjit

AU - Beverland, David

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Introduction: The study aims were to identify the incidence of pelvic adduction during total hip arthroplasty (THA) in lateral decubitus and to determine, when aiming for 35° of apparent operative inclination (AOI), which of 3 operating table positions most accurately obtained a target radiographic inclination (RI) of 42°: (1) horizontal; (2) 7° head-down; (3) patient-specific position based on correction of pelvic adduction.Methods: With patients seated on a levelled theatre table, a ruler incorporating a spirit level was used to draw transverse pelvic lines (TPLs) on the skin overlying the pelvis and sacrum. Subsequently, when positioned in lateral decubitus these lines provided a measure of pelvic adduction. 270 participants were recruited, with 90 randomised to each group for operating table position. In all cases target AOI was 35°, aiming to achieve a target RI of 42°. The primary outcome measure was absolute (unsigned) deviation from the target RI of 42°. Results: 266/270 patients demonstrated pelvic adduction (overall mean 4.4°, range 0– 9.2°). No patients demonstrated pelvic abduction. There were significant differences in RI between each of the 3 groups. The horizontal table group displayed the highest mean RI. The patient specific table position group achieved the smallest absolute deviation from target RI of 42°.Discussion: In lateral decubitus, unrecognised pelvic adduction is common and is an important contributor to unexpectedly high RI. The use of preoperative transverse pelvic lines helps identify pelvic adduction and its subsequent correction reduces variability in RI.

AB - Introduction: The study aims were to identify the incidence of pelvic adduction during total hip arthroplasty (THA) in lateral decubitus and to determine, when aiming for 35° of apparent operative inclination (AOI), which of 3 operating table positions most accurately obtained a target radiographic inclination (RI) of 42°: (1) horizontal; (2) 7° head-down; (3) patient-specific position based on correction of pelvic adduction.Methods: With patients seated on a levelled theatre table, a ruler incorporating a spirit level was used to draw transverse pelvic lines (TPLs) on the skin overlying the pelvis and sacrum. Subsequently, when positioned in lateral decubitus these lines provided a measure of pelvic adduction. 270 participants were recruited, with 90 randomised to each group for operating table position. In all cases target AOI was 35°, aiming to achieve a target RI of 42°. The primary outcome measure was absolute (unsigned) deviation from the target RI of 42°. Results: 266/270 patients demonstrated pelvic adduction (overall mean 4.4°, range 0– 9.2°). No patients demonstrated pelvic abduction. There were significant differences in RI between each of the 3 groups. The horizontal table group displayed the highest mean RI. The patient specific table position group achieved the smallest absolute deviation from target RI of 42°.Discussion: In lateral decubitus, unrecognised pelvic adduction is common and is an important contributor to unexpectedly high RI. The use of preoperative transverse pelvic lines helps identify pelvic adduction and its subsequent correction reduces variability in RI.

U2 - 10.1177/1120700018777480

DO - 10.1177/1120700018777480

M3 - Article

VL - 28

SP - 240

EP - 245

JO - Hip International

JF - Hip International

SN - 1724-6067

IS - 3

ER -