Pelvic mobility before and after total hip arthroplasty
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ORIGINAL PAPER
Pelvic mobility before and after total hip arthroplasty Yasuhiro Homma 1,2 & Seiya Ishii 1 & Naotake Yanagisawa 2 & Hironori Ochi 1 & Tomonori Baba 1 & Hidetoshi Nojiri 1 & Takatoshi Okuda 1 & Kazuo Kaneko 1 Received: 30 April 2020 / Accepted: 26 June 2020 # SICOT aisbl 2020
Abstract Background Pre-operative evaluation of pelvic motion using the sacral slope (SS) has been proposed for risk assessment of dislocation after total hip arthroplasty (THA). The purposes of this study were to elucidate the statistical characteristics of preoperative and post-operative pelvic mobility and investigate the relationship between pre-operative spinopelvic factors and postoperative pelvic mobility. Methods Eighty-six patients with osteoarthritis were assessed. The parameters evaluated were lumbar lordosis angle and the SS in the standing and sitting preo-peratively and post-operatively. The pelvic mobility was defined as the difference in the SS between standing and sitting. The presence of osteoarthritis in the contralateral hip, spondylolisthesis, vertebral compression fracture and lumbar scoliosis was investigated. Results The median (interquartile range) pre-operative and post-operative pelvic mobility was 19.0 (13.75–27.0) and 16.0 (10.0– 25.25), respectively, with significant difference. The pre-operative SS while standing and pre-operative pelvic mobility were associated with post-operative pelvic mobility (r = 0.409, P < 0.05 and r = 0.533, P < 0.05). The multivariate linear regression analysis showed that the following factors contributed to post-operative pelvic mobility: incidence of osteoarthritis in the contralateral hip, lumbar scoliosis, pre-operative SS while standing and pre-operative SS while sitting. Conclusion The pre-operative and post-operative pelvic mobility is not equal and ranges widely among patients. In addition to assessment of pre-operative pelvic mobility, other pre-operative spinopelvic factors may also influence post-operative pelvic mobility, such as the SS while standing and sitting, the condition of the contralateral hip and the presence of scoliosis. Risk assessment for dislocation using these pre-operative factors may be useful before THA. Keywords Pelvic mobility . Sacral slope . Sagittal balance . Total hip arthroplasty . Dislocation
Introduction Dislocation is a major complication after total hip arthroplasty (THA). Correct implant positioning is thought to be a major key to avoiding dislocation. Although the so-called Lewinnek “safe zone” has long been used as the target angle for acetabular cup positioning [1], recent studies have emphasized the importance of assessment of the individual patient’s optimal angle in the standing position [2, 3]. According to the concept
* Yasuhiro Homma [email protected] 1
Department of Orthopaedic Surgery, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
2
Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
of the Lewinnek “safe zone”, the cup should be implanted within a cup inclination ang
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