Operative and Radiographic Acetabular Component Orientation in Total Hip Replacement: Influence of Pelvic Orientation and Surgical Positioning Technique

Megan Rutherford, John D. O'Connor, Harinderjit S. Gill, Janet Hill, David Beverland, Alex B. Lennon, Nicholas J. Dunne

Research output: Contribution to journalArticle

Abstract

Orthopaedic surgeons often experience a mismatch between perceived intra-operative and radiographic acetabular cup orientation. This research aimed to assess the impact of pelvic orientation and surgical positioning technique on operative and radiographic cup orientation. Radiographic orientations for two surgical approaches were computationally simulated: a mechanical alignment guide and a transverse acetabular ligament approach, both in combination with different pelvic orientations. Positional errors were defined as the difference between the target radiographic orientation and that achieved. The transverse acetabular ligament method demonstrated smaller positional errors for radiographic version; 4.0° ± 2.9° as compared to 9.4° ± 7.3° for the mechanical alignment guide method. However, both methods resulted in similar errors in radiographic inclination. Multiple regression analysis showed that intraoperative pelvic rotation about the anterior-posterior axis was a strong predictor for these errors (B TAL = −0.893, B MAG = −0.951, p < 0.01). Application of the transverse acetabular ligament method can reduce errors in radiographic version. However, if the orthopaedic surgeon is referencing off the theatre floor to control inclination when operating in lateral decubitus, this is only reliable if the pelvic sagittal plane is horizontal. There is currently no readily available method for ensuring that this is the case during total hip replacement surgery.

Original languageEnglish
Pages (from-to)7-14
Number of pages8
JournalMedical Engineering & Physics
Volume64
Early online date9 Jan 2019
DOIs
Publication statusPublished - 1 Feb 2019

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Hip Replacement Arthroplasties
Ligaments
Pelvis
Regression Analysis
Research

Keywords

  • Acetabular component inclination
  • Mechanical alignment guide
  • Pelvic orientation
  • Transverse acetabular ligament

ASJC Scopus subject areas

  • Biophysics
  • Biomedical Engineering

Cite this

Operative and Radiographic Acetabular Component Orientation in Total Hip Replacement: Influence of Pelvic Orientation and Surgical Positioning Technique. / Rutherford, Megan; O'Connor, John D.; Gill, Harinderjit S.; Hill, Janet; Beverland, David; Lennon, Alex B.; Dunne, Nicholas J.

In: Medical Engineering & Physics , Vol. 64, 01.02.2019, p. 7-14.

Research output: Contribution to journalArticle

Rutherford, Megan ; O'Connor, John D. ; Gill, Harinderjit S. ; Hill, Janet ; Beverland, David ; Lennon, Alex B. ; Dunne, Nicholas J. / Operative and Radiographic Acetabular Component Orientation in Total Hip Replacement: Influence of Pelvic Orientation and Surgical Positioning Technique. In: Medical Engineering & Physics . 2019 ; Vol. 64. pp. 7-14.
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