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Journal article

Pelvic position and movement during hip replacement.

Abstract:
The orientation of the acetabular component is influenced not only by the orientation at which the surgeon implants the component, but also the orientation of the pelvis at the time of implantation. Hence, the orientation of the pelvis at set-up and its movement during the operation, are important. During 67 hip replacements, using a validated photogrammetric technique, we measured how three surgeons orientated the patient's pelvis, how much the pelvis moved during surgery, and what effect these had on the final orientation of the acetabular component. Pelvic orientation at set-up, varied widely (mean (± 2, standard deviation (sd))): tilt 8° (2sd ± 32), obliquity -4° (2sd ± 12), rotation -8° (2sd ± 14). Significant differences in pelvic positioning were detected between surgeons (p < 0.001). The mean angular movement of the pelvis between set-up and component implantation was 9° (sd 6). Factors influencing pelvic movement included surgeon, approach (posterior > lateral), procedure (hip resurfacing > total hip replacement) and type of support (p < 0.001). Although, on average, surgeons achieved their desired acetabular component orientation, there was considerable variability (2sd ± 16) in component orientation. We conclude that inconsistency in positioning the patient at set-up and movement of the pelvis during the operation account for much of the variation in acetabular component orientation. Improved methods of positioning and holding the pelvis are required.
Publication status:
Published

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Publisher copy:
10.1302/0301-620x.96b7.32107

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Publisher:
British Editorial Society of Bone and Joint Surgery
Journal:
bone and joint journal More from this journal
Volume:
96-B
Issue:
7
Pages:
876-883
Publication date:
2014-07-01
DOI:
EISSN:
2049-4408
ISSN:
2049-4394


Language:
English
Keywords:
Pubs id:
pubs:475839
UUID:
uuid:15745fcf-97f5-40f1-8ead-e77810a052df
Local pid:
pubs:475839
Source identifiers:
475839
Deposit date:
2014-07-18
ARK identifier:

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