Acetabular Placement Accuracy With the Direct Anterior Approach Freehand Technique
| Autor: | Melissa C Soderquist, Ryan D Scully, Anthony S. Unger |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
musculoskeletal diseases
Adult Male medicine.medical_specialty Arthroplasty Replacement Hip Joint Dislocations Body Mass Index 03 medical and health sciences 0302 clinical medicine Intraoperative fluoroscopy Medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Pelvis Aged Retrospective Studies Orthodontics Aged 80 and over 030222 orthopedics business.industry Acetabulum Middle Aged Operating table Surgery medicine.anatomical_structure Treatment Outcome Acetabular component Fluoroscopy Female Hip Joint Anterior approach Hip Prosthesis business Total hip arthroplasty |
| Zdroj: | The Journal of arthroplasty. 32(9) |
| ISSN: | 1532-8406 |
| Popis: | Background Acetabular cup placement in total hip arthroplasty (THA) has been recognized as an important factor in operative success, and accurate cup placement has been the impetus for novel medical technologies. Methods This article examines the cup placement in 955 THAs using a freehand Direct Anterior Approach on a standard operating table. Acetabular anteversion and inclination were determined using the circle theorem. Measurements were divided into safe zone placement determined by Callanan et al as 5°-25° for anteversion and 30°-45° for inclination, as well as by Lewinnek et al as 5°-25° for anteversion and 30°-50° for inclination. Dislocation rate was determined and correlated to safe zone placement. Results Although technology has advanced for cup placement, this investigation shows that a freehand technique demonstrates 0.31% dislocation after THA with an accuracy of 85% for the Lewinnek safe zone and 61% for Callanan, potentially because of the sparing of the posterior hip capsule. Conclusion The direct anterior approach to the hip on a regular operating table is safe and reliable. Our results demonstrate improvement in cup positioning compared with other freehand techniques. Surgeon awareness and control of the position of the pelvis within space optimizes acetabular component accuracy and precision without the need for special equipment, such as intraoperative fluoroscopy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect