Patient Obesity Influences Pelvic Lift During Cup Insertion in Total Hip Arthroplasty Through a Lateral Transgluteal Approach in Supine Position
| Autor: | Christoph Windisch, Linda Krakow, Dimitri Nowack, Georg Matziolis, Benjamin Jacob, Steffen Brodt |
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| Rok vydání: | 2017 |
| Předmět: |
Pelvic tilt
Male medicine.medical_specialty Supine position genetic structures medicine.medical_treatment Arthroplasty Replacement Hip Movement Body Mass Index Pelvis 03 medical and health sciences 0302 clinical medicine medicine Supine Position Humans Orthopedics and Sports Medicine 030212 general & internal medicine Obesity Aged Aged 80 and over 030222 orthopedics business.industry Acetabulum Traction (orthopedics) Middle Aged Circumference Transgluteal approach Surgery body regions Retractor medicine.anatomical_structure Multivariate Analysis Female sense organs Hip Prosthesis business Tomography X-Ray Computed Total hip arthroplasty |
| Zdroj: | The Journal of arthroplasty. 32(9) |
| ISSN: | 1532-8406 |
| Popis: | Background Movement of the pelvis during implantation of total hip arthroplasty (THA) has a major influence on the positioning of the acetabular cup. Strong traction caused by retractors leads to iatrogenic pelvic lift and can thus be partly responsible for cup malpositioning. The objective of this study was to investigate such factors that influence pelvic lift. Methods The dynamic movement of the pelvis was measured during implantation of THA in 67 patients. This was done by measuring the acceleration using the SensorLog app on a smartphone. Results At its maximum, the pelvis was lifted by an average of 6.7°. When impacting the press-fit cup, the surgical side was raised by 4.4° compared with the time of skin incision. This lift at the time of cup implantation correlates significantly with the body mass index and the patient's abdominal and pelvic circumference. Conclusion Every surgeon performing THA must be aware of the pelvic lift during an operation. Especially in patients with a high body mass index, a large abdominal circumference, or a large pelvic circumference, there is an increased risk of malpositioning of the acetabular cup. When impacting the cup, we recommend releasing the traction of the retractor, so that the pelvis can tilt back into its natural position, and thus, the anticipated cup positioning can be implemented as exactly as possible. |
| Databáze: | OpenAIRE |
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