A prospective study of acetabular cup positioning using anatomical landmarks

Dinesh, R (2016) A prospective study of acetabular cup positioning using anatomical landmarks. Masters thesis, Tirunelveli Medical College Hospital, Tirunelveli.


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BACKGROUND : In total hip replacement the placement of the cup is critical as inaccurate placement can cause impingement, accelerated wear and dislocations. The position is assessed by the abduction and the anteversion. The gold standard for these measurements is the CT at the mid coronal and the mid axial sections. The purpose of this study is to verify if the anatomical landmarks of TAN and AAN are reliable in acetabular component placement by evaluating post op CT and rate of dislocations. METHODS : In 53 patients who underwent primary Total Hip Arthroplasty in Tirunelveli medical college, Tirunelveli, the acetabular component placement was done using the anatomical landmarks of TAN and AAN and pre op CT measurements where the angle of abduction (α ) was calculated from the mid coronal section and the angle of anteversion (β) from the mid axial section. This included 34 male and 19 female. RESULTS : The CT had excellent inter and intra observer reliability in calculating the angle of abduction and anteversion. The mean abduction was 43.6 and the mean anteversion was17.9 pre operatively. The mean pre op HHS was 37. The post op CT revealed the mean cup abduction was 40.1 and the anteversion was 16.2 after the component placement using the anatomical landmarks. The post op HHS mean was 86. CONCLUSION : The TAN and the AAN are a reliable alternative anatomical landmark to TAL for guiding anteversion and also additionally helps guiding the abduction of the acetabular component, even if the TAL is not visible as in Archbold grade 3 or the TAL is removed inadvertently when clearing the osteophytes. The pitfall is that this method cannot be used where the TAN and the AAN are not visible or anatomically displaced in cases of severe dysplasia of hip or old malunited fractures of the acetabulum.

Item Type: Thesis (Masters)
Uncontrolled Keywords: prospective study ; acetabular cup positioning ; anatomical landmarks
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 18 Sep 2017 03:14
Last Modified: 21 Sep 2017 02:16
URI: http://repository-tnmgrmu.ac.in/id/eprint/3203

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