NDLI: Quantifying anterior pelvic roll during total hip arthroplasty in the lateral decubitus position

Content Provider	Springer Nature : BioMed Central
Author	Kurmis, Andrew P. Lourens, Ernest C.
Abstract	Background Unintended pelvic positional change is an acknowledged intra-operative problem for hip arthroplasty, seen commonly with procedures performed in the lateral position. If unrecognised, such changes can dramatically alter final acetabular component anteversion potentially resulting in suboptimal construct performance. It has previously been suggested that pelvic roll of just 13° may be enough to place an otherwise perfectly orientated cup outside of conventional ± 10° safe zones. Using the real-time tracking capacity of a commercially available optical navigation system, we aimed to accurately quantify pelvic roll occurring during total hip arthroplasties (THAs) performed in the decubitus position. Methods Prospectively collected data for 107 consecutive, unilateral, THAs were interrogated to determine the magnitude of pelvic movement around a central longitudinal axis (i.e. AP roll). Correlation statistics with patient age and body mass index (BMI) were also calculated. Results A mean pelvic roll of 9.5° was observed, being anterior in 96% of cases. Of these, 18.3% of hips had a magnitude of roll greater than 13°. There were no statistically significant independent correlations observed between age (p = 0.87) or BMI (p = 0.59) and mean roll. Conclusions Errors in achieving acetabular target version may result in numerous post-operative concerns including instability/dislocation, bearing wear, squeaking, range-of-movement limitation and increased revision rate. In a general cohort, our findings suggest a mean anterior pelvic roll during THA of nearly 10°. Without purposeful correction, this may cause substantial deviation from intended target positions. Future work is indicated to map changing pelvic roll during THA which is likely to follow a nonlinear trajectory. Level of evidence: IV. .
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-023-04350-y.pdf
Ending Page	7
Page Count	7
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-023-04350-y
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2023-11-14
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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