Change in cup orientation from supine to standing posture

• Verfasst von: Vorimore, Camille [VerfasserIn]
• Verfasst von: Verhaegen, Jeroen C. F. [VerfasserIn]
• Verfasst von: Innmann, Moritz Maximilian [VerfasserIn]
• Verfasst von: Monk, A. Paul [VerfasserIn]
• Verfasst von: Ling, Christopher [VerfasserIn]
• Verfasst von: Grammatopoulos, George [VerfasserIn]
• Titel: Change in cup orientation from supine to standing posture
• Titelzusatz: a prospective cohort study of 419 total hip arthroplasties
• Verf.angabe: Camille Vorimore, Jeroen C. F. Verhaegen, Moritz Innmann, A. Paul Monk, Christopher Ling, and George Grammatopoulos
• E-Jahr: 2024
• Jahr: 2024-07-22
• Umfang: 8 S.
• Fussnoten: Gesehen am 16.12.2024
• Titel Quelle: Enthalten in: Acta orthopaedica
• Ort Quelle: London [u.a.] : Taylor & Francis Group, 2005
• Jahr Quelle: 2024
• Band/Heft Quelle: 95(2024), Seite 425-432
• ISSN Quelle: 1745-3682
• DOI: doi:10.2340/17453674.2024.41091
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Acetabular cup orientation
• Sach-SW: Anteversion
• Sach-SW: Pelvic Tilt
• Sach-SW: Spinopelvic assessment
• Sach-SW: Total hip arthroplasty
• K10plus-PPN: 1912437325

Abstract

Background and purpose: Arthroplasty surgeons traditionally assess cup orientation after total hip arthroplasty (THA) on supine radiographs. Contemporary hip-spine analyses provide information on standing, functional cup orientation. This study aims to (i) characterize cup orientations when supine and standing; (ii) determine orientation differences between postures; and (iii) identify factors associated with magnitude of orientation differences.Methods: This is a 2-center, multi-surgeon, prospective, consecutive cohort study. 419 primary THAs were included (57% women; mean age: 64 years, standard deviation [SD] 11). All patients underwent supine and standing antero-posterior pelvic and lateral spinopelvic radiographs. Cup orientation and spinopelvic parameters were measured. Target cup orientation was defined as inclination/anteversion of 40°/20° ± 10°. A change in orientation (Δinclination/Δanteversion) between postures > 5° was defined as clinically significant. Variability was defined as 2 x SD.Results: Inclination increased from 40° (supine) to 42° (standing) corresponding to a Δinclination of 2° (95% confidence interval [CI] 2-3). Anteversion increased from 25° (supine) to 30° (standing) corresponding to a Δanteversion of 5° (CI 5-6). When supine, 69% (CI 65-74) of THAs were within target, but only 44% (CI 39-49) were within target when standing, resulting in a further 26% (CI 21-30) being out of target when standing. From supine to standing, a clinically significant change in anteversion (> 5°) was seen in 47% (CI 42-52) of cases. Δanteversion was higher in women than in men (6°, CI 5-7 vs 5°, CI 4-5) corresponding to a difference of 1° (CI 1-2), which was dependent on tilt change, standing cup anteversion, age, and standing pelvic tilt.Conclusion: Cup inclination and version increase upon standing but significant variability exists due to patient factors.