How unattended lateral pelvic tilt during total hip arthroplasty will affect acetabular cup inclination angle, a simplified demonstration on a sawbone pelvis model



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Abstract

Introduction: Proper acetabular cup positioning, including inclination angle, affects long-term outcomes and total hip arthroplasty (THA) survival. This experiment aims to explain how unattended lateral pelvic tilt will affect the cup inclination angle during THA. Methods: A normal pelvis sawbone model was fixed to an operative table, an acetabular cup attached to its inserter was applied to the sawbone model acetabulum aiming at an inclination angle of 40° in relation to the floor level, while the pelvis was placed in three different positions, neutral where the line connecting the anterior superior iliac spine (ASIS) is perpendicular (90°) to the floor level, adduction and abduction where the angle is less (-10) and more (+10) than 90° respectively. Then, the cup inclination angle in relation to the interischial line was measured. Results: As the pelvis was in a neutral position, the final cup inclination angle was the same as the intended angle (40°). When the sawbone model was adducted, the resultant cup inclination was 10° more (50°) than the intended angle. While in pelvis abduction, the resultant cup inclination was 10° less (30°) than the intended angle. In both situations, the difference was equal to the amount of lateral pelvic tilt. Conclusions: In this experiment, we proved the profound effect of unattended lateral pelvic tilt during THA after patient positioning and draping on the cup inclination angle.

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About the authors

Ahmed A. Khalifa

Orthopaedic Department, Qena faculty of medicine and university hospital, South valley university, Qena, Egypt

Author for correspondence.
Email: ahmed_adel0391@med.svu.edu.eg
ORCID iD: 0000-0002-0710-6487
Scopus Author ID: 57191749405
Egypt

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