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BMC Musculoskeletal Disorders

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Open Access 01-12-2021 | Hip-TEP | Research

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

Authors: Tingxian Ling, Zichuan Ding, Mingcheng Yuan, Kai Zhou, Zongke Zhou

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

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. The patients were divided into normal pelvis (NP) group and backward pelvis (BP) group by sagittal pelvic malrotation assessed by APPA, the angle between the vertical and the APP on standing lateral pelvic radiographs preoperatively. Cup anteversion and inclination and that out of the safe zones were measured and compared in two groups. The demographic data, clinical results, and complications of patients were also compared.

Results

Backward pelvic malrotation were found in 60.6 % of this cohort of THA candidates. The mean angle of both inclination and anteversion in BP group were significantly larger than that in NP group. The rate of cup for anteversion and inclination above the safe zone in BP group was significantly larger than that in NP group. There were 4 patients in BP group recording anterior hip dislocation after surgery. Other complications were not observed at last follow-up.

Conclusions

Backward pelvis malrotation may increase TAL guided cup inclination and anteversion, which were inclined to became outlier above the safe zone. This likely increase the rates of dislocation after THA. For the patients with pelvis malrotation, cup positioning should be performed individually instead of guided by TAL.

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Title: The influence of sagittal pelvic malrotation on transverse acetabular ligament guided cup orientation: a retrospective cohort study
Authors: Tingxian Ling
Zichuan Ding
Mingcheng Yuan
Kai Zhou
Zongke Zhou
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Hip-TEP
Hip-TEP
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04391-6

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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