dc.contributor.author
Haffer, Henryk
dc.contributor.author
Wang, Zhen
dc.contributor.author
Hu, Zhouyang
dc.contributor.author
Hipfl, Christian
dc.contributor.author
Pumberger, Matthias
dc.date.accessioned
2023-07-12T12:11:44Z
dc.date.available
2023-07-12T12:11:44Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/40063
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-39785
dc.description.abstract
Introduction: Spinopelvic mobility was identified as a contributing factor for total hip arthroplasty (THA) instability. The influence of spinopelvic function on acetabular cup positioning has not yet been sufficiently investigated in a prospective setting. Therefore, our study aimed (1) to assess cup inclination and anteversion in standing and sitting based on spinopelvic mobility, (2) to identify correlations between cup position and spinopelvic function, (3) and to determine the influence of the individual spinal segments, spinal sagittal balance, and spinopelvic characteristics on the mobility groups.
Materials and methods: A prospective study assessing 197 THA patients was conducted with stereoradiography in standing and sitting position postoperatively. Two independent investigators determined cup anteversion and inclination, C7-Sagittal vertical axis, cervical lordosis (CL), thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope, pelvic tilt (PT), anteinclination (AI), and pelvic femoral angle (PFA). Spinopelvic mobility is defined based on increment PT = PTstanding - PTsitting as increment PT < 10 degrees stiff, increment PT >= 10-30 degrees normal, and increment PT > 30 degrees hypermobile. Pearson coefficient represented correlations between the cup position and spinopelvic parameters.
Results: Significant differences were demonstrated for cup anteversion (stiff/hypermobile 29.3 degrees/40.1 degrees; p < 0.000) and inclination (stiff/hypermobile 43.5 degrees/60.2 degrees; p < 0.000) in sitting, but not in standing position. increment (standing/sitting) of the cup anteversion (stiff/neutral/hypermobile 5.8 degrees/12.4 degrees/19.9 degrees; p < 0.000) and inclination (stiff/neutral/hypermobile 2.3 degrees/11.2 degrees/18.8 degrees; p < 0.000) revealed significant differences between the mobility groups. The acetabular cup position in sitting, was correlated with lumbar flexibility ( increment LL) and spinopelvic mobility. Significant differences were detected between the mobility types and acetabular orientation (AI sit:stiff/hypermobile 47.6 degrees/65.4 degrees; p < 0.000) and hip motion ( increment PFA:stiff/hypermobile 65.8 degrees/37.3 degrees; p < 0.000). Assessment of the spinal segments highlighted the role of lumbar flexibility ( increment LL:stiff/hypermobile 9.9 degrees/36.2 degrees; p < 0.000) in the spinopelvic complex.
Conclusion: The significantly different acetabular cup positions in sitting and in the increment between standing and sitting and the significantly altered spinopelvic characteristics in terms of stiff and hypermobile spinopelvic mobility underlined the consideration for preoperative functional radiological assessment. Identifying the patients with altered spinopelvic mechanics due to a standardized screening algorithm is necessary to provide safe acetabular cup positioning. The proximal spinal segments appeared not to be involved in the spinopelvic function.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Spinopelvic alignment
en
dc.subject
Spinal sagittal balance
en
dc.subject
Total hip arthroplasty dislocation
en
dc.subject
Total hip replacement
en
dc.subject
Spinopelvic stiffness
en
dc.subject
Spinopelvic hypermobility
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Acetabular cup position differs in spinopelvic mobility types: a prospective observational study of primary total hip arthroplasty patients
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1007/s00402-021-04196-1
dcterms.bibliographicCitation.journaltitle
Archives of Orthopaedic and Trauma Surgery
dcterms.bibliographicCitation.number
10
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.pagestart
2979
dcterms.bibliographicCitation.pageend
2989
dcterms.bibliographicCitation.volume
142
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.funding
Springer Nature DEAL
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
34633512
dcterms.isPartOf.eissn
1434-3916