The effect of orientation of the acetabular component on outcome following total hip arthroplasty with small diameter hard-on-soft bearings

G Grammatopoulos, G E R Thomas, H Pandit, D J Beard, H S Gill, D W Murray

Research output: Contribution to journalArticle

27 Citations (Scopus)
60 Downloads (Pure)

Abstract

We assessed the orientation of the acetabular component in 1070 primary total hip arthroplasties with hard-on-soft, small diameter bearings, aiming to determine the size and site of the target zone that optimises outcome. Outcome measures included complications, dislocations, revisions and ΔOHS (the difference between the Oxford Hip Scores pre-operatively and five years post-operatively). A wide scatter of orientation was observed (2sd 15°). Placing the component within Lewinnek's zone was not associated withimproved outcome. Of the different zone sizes tested (± 5°, ± 10° and ± 15°), only ± 15° was associated with a decreased rate of dislocation. The dislocation rate with acetabular components inside an inclination/anteversion zone of 40°/15° ± 15° was four times lower than those outside. The only zone size associated with statistically significant and clinically important improvement in OHS was ± 5°. The best outcomes (ΔOHS > 26) were achieved with a 45°/25° ± 5° zone. This study demonstrated that with traditional technology surgeons can only reliably achieve a target zone of ±15°. As the optimal zone to diminish the risk of dislocation is also ±15°, surgeons should be able to achieve this. This is the first study to demonstrate that optimal orientation of the acetabular component improves the functional outcome. However, the target zone is small (± 5°) and cannot, with current technology, be consistently achieved. Cite this article: Bone Joint J 2015;97-B:164-72.

Original languageEnglish
Pages (from-to)164-72
Number of pages9
JournalThe Bone & Joint Journal
Volume97-B
Issue number2
DOIs
Publication statusPublished - Feb 2015

Fingerprint

Arthroplasty
Hip
Technology
Joints
Outcome Assessment (Health Care)
Bone and Bones
Surgeons

Cite this

The effect of orientation of the acetabular component on outcome following total hip arthroplasty with small diameter hard-on-soft bearings. / Grammatopoulos, G; Thomas, G E R; Pandit, H; Beard, D J; Gill, H S; Murray, D W.

In: The Bone & Joint Journal, Vol. 97-B, No. 2, 02.2015, p. 164-72.

Research output: Contribution to journalArticle

Grammatopoulos, G ; Thomas, G E R ; Pandit, H ; Beard, D J ; Gill, H S ; Murray, D W. / The effect of orientation of the acetabular component on outcome following total hip arthroplasty with small diameter hard-on-soft bearings. In: The Bone & Joint Journal. 2015 ; Vol. 97-B, No. 2. pp. 164-72.
@article{fde4dacdf9434a2d8fd0fd2c2f1ffdd3,
title = "The effect of orientation of the acetabular component on outcome following total hip arthroplasty with small diameter hard-on-soft bearings",
abstract = "We assessed the orientation of the acetabular component in 1070 primary total hip arthroplasties with hard-on-soft, small diameter bearings, aiming to determine the size and site of the target zone that optimises outcome. Outcome measures included complications, dislocations, revisions and ΔOHS (the difference between the Oxford Hip Scores pre-operatively and five years post-operatively). A wide scatter of orientation was observed (2sd 15°). Placing the component within Lewinnek's zone was not associated withimproved outcome. Of the different zone sizes tested (± 5°, ± 10° and ± 15°), only ± 15° was associated with a decreased rate of dislocation. The dislocation rate with acetabular components inside an inclination/anteversion zone of 40°/15° ± 15° was four times lower than those outside. The only zone size associated with statistically significant and clinically important improvement in OHS was ± 5°. The best outcomes (ΔOHS > 26) were achieved with a 45°/25° ± 5° zone. This study demonstrated that with traditional technology surgeons can only reliably achieve a target zone of ±15°. As the optimal zone to diminish the risk of dislocation is also ±15°, surgeons should be able to achieve this. This is the first study to demonstrate that optimal orientation of the acetabular component improves the functional outcome. However, the target zone is small (± 5°) and cannot, with current technology, be consistently achieved. Cite this article: Bone Joint J 2015;97-B:164-72.",
author = "G Grammatopoulos and Thomas, {G E R} and H Pandit and Beard, {D J} and Gill, {H S} and Murray, {D W}",
year = "2015",
month = "2",
doi = "10.1302/0301-620X.97B2.34294",
language = "English",
volume = "97-B",
pages = "164--72",
journal = "The Bone & Joint Journal",
issn = "2049-4394",
publisher = "British Editorial Society of Bone and Joint Surgery",
number = "2",

}

TY - JOUR

T1 - The effect of orientation of the acetabular component on outcome following total hip arthroplasty with small diameter hard-on-soft bearings

AU - Grammatopoulos, G

AU - Thomas, G E R

AU - Pandit, H

AU - Beard, D J

AU - Gill, H S

AU - Murray, D W

PY - 2015/2

Y1 - 2015/2

N2 - We assessed the orientation of the acetabular component in 1070 primary total hip arthroplasties with hard-on-soft, small diameter bearings, aiming to determine the size and site of the target zone that optimises outcome. Outcome measures included complications, dislocations, revisions and ΔOHS (the difference between the Oxford Hip Scores pre-operatively and five years post-operatively). A wide scatter of orientation was observed (2sd 15°). Placing the component within Lewinnek's zone was not associated withimproved outcome. Of the different zone sizes tested (± 5°, ± 10° and ± 15°), only ± 15° was associated with a decreased rate of dislocation. The dislocation rate with acetabular components inside an inclination/anteversion zone of 40°/15° ± 15° was four times lower than those outside. The only zone size associated with statistically significant and clinically important improvement in OHS was ± 5°. The best outcomes (ΔOHS > 26) were achieved with a 45°/25° ± 5° zone. This study demonstrated that with traditional technology surgeons can only reliably achieve a target zone of ±15°. As the optimal zone to diminish the risk of dislocation is also ±15°, surgeons should be able to achieve this. This is the first study to demonstrate that optimal orientation of the acetabular component improves the functional outcome. However, the target zone is small (± 5°) and cannot, with current technology, be consistently achieved. Cite this article: Bone Joint J 2015;97-B:164-72.

AB - We assessed the orientation of the acetabular component in 1070 primary total hip arthroplasties with hard-on-soft, small diameter bearings, aiming to determine the size and site of the target zone that optimises outcome. Outcome measures included complications, dislocations, revisions and ΔOHS (the difference between the Oxford Hip Scores pre-operatively and five years post-operatively). A wide scatter of orientation was observed (2sd 15°). Placing the component within Lewinnek's zone was not associated withimproved outcome. Of the different zone sizes tested (± 5°, ± 10° and ± 15°), only ± 15° was associated with a decreased rate of dislocation. The dislocation rate with acetabular components inside an inclination/anteversion zone of 40°/15° ± 15° was four times lower than those outside. The only zone size associated with statistically significant and clinically important improvement in OHS was ± 5°. The best outcomes (ΔOHS > 26) were achieved with a 45°/25° ± 5° zone. This study demonstrated that with traditional technology surgeons can only reliably achieve a target zone of ±15°. As the optimal zone to diminish the risk of dislocation is also ±15°, surgeons should be able to achieve this. This is the first study to demonstrate that optimal orientation of the acetabular component improves the functional outcome. However, the target zone is small (± 5°) and cannot, with current technology, be consistently achieved. Cite this article: Bone Joint J 2015;97-B:164-72.

UR - http://dx.doi.org/10.1302/0301-620X.97B2.34294

U2 - 10.1302/0301-620X.97B2.34294

DO - 10.1302/0301-620X.97B2.34294

M3 - Article

VL - 97-B

SP - 164

EP - 172

JO - The Bone & Joint Journal

JF - The Bone & Joint Journal

SN - 2049-4394

IS - 2

ER -