Variability of Pelvic Orientation in the Lateral Decubitus Position: Are External Alignment Guides Trustworthy?

The Journal of Arthroplasty
Jesse E OteroThomas K Fehring

Abstract

The position of the acetabular component in total hip arthroplasty (THA) is critical for success. However, this remains the most variable aspect of the surgery. We hypothesized that there is wide variation in pelvic orientation in the lateral decubitus position. We sought to determine the variability in pelvic positioning and the frequency of pelvic malposition during THA in lateral decubitus with regard to pelvic tilt and pelvic rotation. We analyzed preoperative standing and intraoperative anteroposterior pelvis X-rays in 248 consecutive THAs performed in lateral decubitus by one surgeon. Pelvic tilt and rotation were determined for preoperative and intraoperative X-rays. Proper intraoperative positioning was defined as less than 10° change in tilt or rotation between preoperative and intraoperative X-rays. With regard to pelvic tilt, the intraoperative position was proper in 188 (76%) cases. There was a pelvic tilt discrepancy of 10°-20° in 43 (17.5%) cases and greater than 20° in 16 (6.5%) patients. With regard to pelvic rotation, the intraoperative position was proper in 202 (81%) cases. There was a pelvic rotation discrepancy of 10°-20° in 38 (15.4%) cases and greater than 20° in 7 (2.8%) cases. In 248 cases, only 154 (62...Continue Reading

Citations

Feb 6, 2020·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Tomonori TetsunagaToshifumi Ozaki
Jul 18, 2020·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Jacob M WilsonGeorge N Guild
Oct 15, 2020·The Journal of Arthroplasty·Matthew J BraswellThomas K Fehring
Oct 26, 2021·Current Reviews in Musculoskeletal Medicine·Jacob P SiebenmorgenJeffrey B Stambough
Jan 19, 2022·Orthopaedics & Traumatology, Surgery & Research : OTSR·Christopher L HoehmannDavid K Galos

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