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Modern cup alignment techniques in total hip arthroplasty: A systematic review.

Abstract：

INTRODUCTION:A systematic review was conducted to assess the clinical and radiological outcomes of the alternative surgical techniques that consider the dynamic aspect of the acetabular orientation when aligning a cup (pelvic tilt-, lumbo-pelvic kinematics-, and spine-hip relationship-adjusted cup alignment techniques). METHOD:Eight eligible articles reported the outcomes of total hip arthroplasty (THA) performed with alternative techniques. Clinical and radiological data were extracted. One study had a control group of patients who underwent conventional THAs (level III) while the seven other studies were level IV. Computer navigation system (CAS), Optimized Positioning System (OPS™), and manual instrumentation were used to align components in four, two, and two studies, respectively. A meta-analysis was not carried out because there was a lack of homogeneity between included articles regarding the method to position the cup and the nature of the reported data. RESULTS:THA performed with alternative techniques had an early dislocation rate ranging from 0 to 1.9%, no unexpected catastrophic failure, and acceptable radiographic cup orientations. One study compared kinematically and mechanically aligned THAs and found no dislocation in either groups, similar patient reported outcome measures (43 Oxford-12 Score for both groups), and similar proportions of cup in the Lewinnek zone (respectively 65% and 70%). DISCUSSION/CONCLUSION:Alternative methods accounting for the functional acetabular orientation seem to be clinically safe and effective in the early-term, and generate acceptable cup orientation on radiographs. Their values compare to those of more conventional techniques for cup implantation remain to be determined. We developed a classification of the multiple methods for aligning an acetabular component. LEVEL OF EVIDENCE:IV, systematic review of level III and IV studies.

journal_name

Orthop Traumatol Surg Res

journal_title

Orthopaedics & traumatology, surgery & research : OTSR

authors

Maillot C,Harman C,Villet L,Cobb J,Rivière C

doi

10.1016/j.otsr.2019.03.015

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

907-913

issue

5

issn

1877-0568

pii

S1877-0568(19)30139-2

journal_volume

105

pub_type

杂志文章

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