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Published in: International Orthopaedics 4/2018

01-04-2018 | Original Paper

A retrospective study on the relationship between altered native acetabular angle and vertical implant malpositioning

Authors: Jorge Rojas, Maria Bautista, Guillermo Bonilla, Omar Amado, Elina Huerfano, Daniel Monsalvo, Adolfo Llinás, José Navas

Published in: International Orthopaedics | Issue 4/2018

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Abstract

Purpose

Acetabular cup positioning in extreme angles of vertical position affects both stability and long-term survivorship of total hip arthroplasty. The purpose of this study is to determine whether native Sharp’s angle is associated with an increased abduction angle of the acetabular component.

Methods

Consecutive patients who underwent primary total hip replacement between February 2012 and August 2015 were included. Vertical positioning of acetabular implant in the antero-posterior post-operative radiographs were measured. The proportion of implants positioned outside the safe zone (40° ± 10°) was calculated and through a multivariate analysis, Sharp’s angle and other factors possibly associated with cup malpositioning were evaluated.

Results

Five hundred twenty-eight hip arthroplasties were analyzed. Prevalence of cup malpositioning was 7.6% and 25 patients had an altered native acetabular angle. An altered pre-operative Sharp’s angle was associated with a higher risk of vertical malpositioning of the acetabular component (OR 2.51 IC 95%: 1.17–5.39) (p = 0.02). Body mass index, surgeon’s volume, size of the implant, gender, pre-operative diagnose and age, were not associated with the position of the cup.

Conclusions

The alteration of the Sharp’s angle as an indicator of hip dysplasia in native hips increases the odds of acetabular cup malpositioning. Other factors explored did not correlate with the position of the acetabular prosthesis. Systematic assessment of Sharp’s angle should be included in the pre-operative planning of primary hip arthroplasty.
Literature
3.
go back to reference Merle C, Grammatopoulos G, Waldstein W et al (2013) Comparison of native anatomy with recommended safe component orientation in total hip arthroplasty for primary osteoarthritis. J Bone Joint Surg Am 95–A:e172–e179 Merle C, Grammatopoulos G, Waldstein W et al (2013) Comparison of native anatomy with recommended safe component orientation in total hip arthroplasty for primary osteoarthritis. J Bone Joint Surg Am 95–A:e172–e179
5.
8.
9.
go back to reference Murayama T, Ohnishi H, Mori T et al (2015) A novel non-invasive mechanical technique of cup and stem placement and leg length adjustment in total hip arthroplasty for dysplastic hips. Int Orthop 39:1057–1064. doi:10.1007/s00264-014-2613-6 CrossRefPubMed Murayama T, Ohnishi H, Mori T et al (2015) A novel non-invasive mechanical technique of cup and stem placement and leg length adjustment in total hip arthroplasty for dysplastic hips. Int Orthop 39:1057–1064. doi:10.​1007/​s00264-014-2613-6 CrossRefPubMed
11.
12.
go back to reference Korduba L, Essner A, Pivec R et al (2014) Effect of acetabular cup abduction angle on wear of ultrahigh-molecular-weight polyethylene in hip simulator testing. Am J Orthop 43:466–471PubMed Korduba L, Essner A, Pivec R et al (2014) Effect of acetabular cup abduction angle on wear of ultrahigh-molecular-weight polyethylene in hip simulator testing. Am J Orthop 43:466–471PubMed
13.
go back to reference Lewinnek G, Lewis J, Tarr R et al (1978) Dislocations after total hip-replacement arthroplasties. J Bone Jt Surg Am 60:217–220CrossRef Lewinnek G, Lewis J, Tarr R et al (1978) Dislocations after total hip-replacement arthroplasties. J Bone Jt Surg Am 60:217–220CrossRef
14.
go back to reference Barrack R (2003) Dislocation after total hip arthroplasty: implant design and orientation. J Am Acad Orthop Surg 11:89–99CrossRefPubMed Barrack R (2003) Dislocation after total hip arthroplasty: implant design and orientation. J Am Acad Orthop Surg 11:89–99CrossRefPubMed
15.
go back to reference Callanan M, Jarrett B, Bragdon C et al (2011) The john charnley award: risk factors for cup malpositioning: quality improvement through a joint registry at a tertiary hospital. Clin Orthop Relat Res 469:319–329. doi:10.1007/s11999-010-1487-1 CrossRefPubMed Callanan M, Jarrett B, Bragdon C et al (2011) The john charnley award: risk factors for cup malpositioning: quality improvement through a joint registry at a tertiary hospital. Clin Orthop Relat Res 469:319–329. doi:10.​1007/​s11999-010-1487-1 CrossRefPubMed
17.
go back to reference Seagrave KG, Troelsen A, Malchau H et al (2016) Acetabular cup position and risk of dislocation in primary total hip arthroplasty a systematic review of the literature. Acta Orthop 87:10–17. doi:10.1080/17453674.2016.1251255 Seagrave KG, Troelsen A, Malchau H et al (2016) Acetabular cup position and risk of dislocation in primary total hip arthroplasty a systematic review of the literature. Acta Orthop 87:10–17. doi:10.​1080/​17453674.​2016.​1251255
18.
go back to reference Gromov K, Greene ME, Huddleston JI et al (2015) Acetabular dysplasia and surgical approaches other than direct anterior increases risk for Malpositioning of the acetabular component in total hip arthroplasty. J Arthroplast. doi:10.1016/j.arth.2015.10.045 Gromov K, Greene ME, Huddleston JI et al (2015) Acetabular dysplasia and surgical approaches other than direct anterior increases risk for Malpositioning of the acetabular component in total hip arthroplasty. J Arthroplast. doi:10.​1016/​j.​arth.​2015.​10.​045
20.
21.
go back to reference Archbold H, Mockford B, Molloy D et al (2006) The transverse acetabular ligament: an aid to orientation of the acetabular component during primary total hip replacement: a preliminary study of 1000 cases investigating postoperative stability. J Bone Joint Surg Br 88:883–886. doi:10.1302/0301-620X.88B7.17577 CrossRefPubMed Archbold H, Mockford B, Molloy D et al (2006) The transverse acetabular ligament: an aid to orientation of the acetabular component during primary total hip replacement: a preliminary study of 1000 cases investigating postoperative stability. J Bone Joint Surg Br 88:883–886. doi:10.​1302/​0301-620X.​88B7.​17577 CrossRefPubMed
23.
24.
27.
go back to reference Bayraktar V, Weber M, von Kunow F et al (2016) Accuracy of measuring acetabular cup position after total hip arthroplasty: comparison between a radiographic planning software and three-dimensional computed tomography. Int Orthop. doi:10.1007/s00264-016-3240-1 Bayraktar V, Weber M, von Kunow F et al (2016) Accuracy of measuring acetabular cup position after total hip arthroplasty: comparison between a radiographic planning software and three-dimensional computed tomography. Int Orthop. doi:10.​1007/​s00264-016-3240-1
28.
go back to reference Tang W, Chiu K, Kwan M, Ng T (2007) Sagittal pelvic mal-rotation and positioning of the acetabular component in total hip arthroplasty: three-dimensional computer model analysis. J Orthop Res 25:766–771. doi:10.1002/jor Tang W, Chiu K, Kwan M, Ng T (2007) Sagittal pelvic mal-rotation and positioning of the acetabular component in total hip arthroplasty: three-dimensional computer model analysis. J Orthop Res 25:766–771. doi:10.​1002/​jor
29.
go back to reference Buckland AJ, Vigdorchik J, Schwab FJ et al (2015) Acetabular anteversion changes due to spinal deformity correction: bridging the gap between hip and spine surgeons. J Bone Joint Surg Am 97:1913–1920. doi:10.2106/JBJS.O.00276 Buckland AJ, Vigdorchik J, Schwab FJ et al (2015) Acetabular anteversion changes due to spinal deformity correction: bridging the gap between hip and spine surgeons. J Bone Joint Surg Am 97:1913–1920. doi:10.​2106/​JBJS.​O.​00276
32.
go back to reference Wassilew GI, Perka C, Janz V et al (2012) Use of an ultrasound-based navigation system for an accurate acetabular positioning in total hip arthroplasty. A prospective, randomized, controlled study. J Arthroplast 27:687–694. doi:10.1016/j.arth.2011.06.038 Wassilew GI, Perka C, Janz V et al (2012) Use of an ultrasound-based navigation system for an accurate acetabular positioning in total hip arthroplasty. A prospective, randomized, controlled study. J Arthroplast 27:687–694. doi:10.​1016/​j.​arth.​2011.​06.​038
Metadata
Title
A retrospective study on the relationship between altered native acetabular angle and vertical implant malpositioning
Authors
Jorge Rojas
Maria Bautista
Guillermo Bonilla
Omar Amado
Elina Huerfano
Daniel Monsalvo
Adolfo Llinás
José Navas
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 4/2018
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3584-1

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