Novel lateral support system increases stability and reduces angular error in total hip arthroplasty: A case control study

Year 2022, Volume: 6 Issue: 2, 186 - 190, 01.02.2022

Mirza Zafer Dağtaş , Ömer Kays Ünal , Turan Nacefov Ender Ugutmen

https://doi.org/10.28982/josam.1049928

Abstract

Background/Aim: Intraoperative changes in patient position or other changes that would disrupt the decisive position during preoperative preparation would directly have a negative impact on acetabular cup orientation in patients undergoing total hip arthroplasty. This study aimed to compare the standard support system and a novel lateral support system (Maltepe), which ensures stable lateral decubitus positioning during the perioperative period, in patients undergoing total hip arthroplasty with the posterolateral approach.
Methods: Patients operated in our department for osteoarthritis of the hip between 2012 - 2019 were included in this case-control study retrospectively. 46 and 41 patients were prepared for surgery in lateral decubitus position using the classical (Group 1) and novel (Group 2) lateral support systems, respectively. The groups were compared in terms of demographic characteristics, duration of preparation, anteversion and inclination, and Harris Hip scores.
Results: Mean patient age was 66.89 (7.53). There was no significant difference between the two groups in terms of age (P=0.546), gender (P=1.00), body mass index (P=0.302) and the operative side (P=0.724). Duration of preparation and absolute deviation values from 15 degrees and 45 degrees were significantly better in group 2 compared to group 1 (P<0.01). There was no significant difference between the Harris Hip Scores of two groups.
Conclusion: We demonstrated that the novel support system we developed provided more successful outcomes than the classical system in terms of acetabular cup orientation.

Keywords

Arthroplasty, Hip, Lateral decubitus, Surgical preparation time, Surgical positioning

References

• 1. Singh JA. Epidemiology of knee and hip arthroplasty: a systematic review. Open Orthop J. 2011;5:80-5.
• 2. Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1323-30.
• 3. Abdelaal MS, Restrepo C, Sharkey PF. Global Perspectives on Arthroplasty of Hip and Knee Joints. Orthop Clin North Am. 2020;51(2):169-76.
• 4. Laupacis A, Bourne R, Rorabeck C, Feeny D, Wong C, Tugwell P, et al. The effect of elective total hip replacement on health-related quality of life. J Bone Joint Surg Am. 1993;75(11):1619-26.
• 5. Pai VS. A comparison of three lateral approaches in primary total hip replacement. Int Orthop. 1997;21(6):393-8.
• 6. Ritter MA, Harty LD, Keating ME, Faris PM, Meding JB. A clinical comparison of the anterolateral and posterolateral approaches to the hip. Clin Orthop Relat Res. 2001(385):95-9.
• 7. Unger AS, Stronach BM, Bergin PF, Nogler M. Direct anterior total hip arthroplasty. Instr Course Lect. 2014;63:227-38.
• 8. Huerfano E, Bautista M, Huerfano M, Nossa JM. Use of Surgical Approach Is Not Associated With Instability After Primary Total Hip Arthroplasty: A Meta-analysis Comparing Direct Anterior and Posterolateral Approaches. J Am Acad Orthop Surg. 2020;29(22):e1126-40.
• 9. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978;60(2):217-20.
• 10. González Della Valle A, Sharrock N, Barlow M, Caceres L, Go G, Salvati EA. The modern, hybrid total hip arthroplasty for primary osteoarthritis at the Hospital for Special Surgery. Bone Joint J. 2016;98-b(1 Suppl A):54-9.
• 11. Gonzalez Della Valle A, Shanaghan K, Benson JR, Carroll K, Cross M, Mclawhorn A, et al. Pelvic pitch and roll during total hip arthroplasty performed through a posterolateral approach. A potential source of error in free-hand cup positioning. Int Orthop. 2019;43(8):1823-9.
• 12. Buğlak F, Aksekili A, Kılıçarslan K, Anaforoglu BK, Korkmaz İ. A Comparison of Anterolateral and Posterolateral Approaches in Primary Total Hip Arthroplasty. Medical Journal of Islamic World Academy of Sciences. 2017;25:1-5.
• 13. Seagrave KG, Troelsen A, Malchau H, Husted H, Gromov K. Acetabular cup position and risk of dislocation in primary total hip arthroplasty. Acta Orthop. 2017;88(1):10-7.
• 14. Biedermann R, Tonin A, Krismer M, Rachbauer F, Eibl G, Stöckl B. Reducing the risk of dislocation after total hip arthroplasty: the effect of orientation of the acetabular component. J Bone Joint Surg Br. 2005;87(6):762-9.
• 15. Del Schutte H, Jr., Lipman AJ, Bannar SM, Livermore JT, Ilstrup D, Morrey BF. Effects of acetabular abduction on cup wear rates in total hip arthroplasty. J Arthroplasty. 1998;13(6):621-6.
• 16. Kennedy JG, Rogers WB, Soffe KE, Sullivan RJ, Griffen DG, Sheehan LJ. Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. J Arthroplasty. 1998;13(5):530-4.
• 17. Leslie IJ, Williams S, Isaac G, Ingham E, Fisher J. High cup angle and microseparation increase the wear of hip surface replacements. Clin Orthop Relat Res. 2009;467(9):2259-65.
• 18. Mcarthur BA, Vulcano E, Cross M, Nguyen J, Della Valle AG, Salvati E. Acetabular component orientation in total hip arthroplasty: the impact of obesity. Hip Int. 2014;24(3):263-9.
• 19. Seagrave KG, Troelsen A, Madsen BG, Husted H, Kallemose T, Gromov K. Can Surgeons Reduce the Risk for Dislocation After Primary Total Hip Arthroplasty Performed Using the Posterolateral Approach? J Arthroplasty. 2017;32(10):3141-6.
• 20. Fujishiro T, Hiranaka T, Hashimoto S, Hayashi S, Kurosaka M, Kanno T, et al. The effect of acetabular and femoral component version on dislocation in primary total hip arthroplasty. International Orthopaedics. 2016;40(4):697-702.
• 21. Wang L, Trousdale RT, Ai S, An KN, Dai K, Morrey BF. Dislocation after total hip arthroplasty among patients with developmental dysplasia of the hip. J Arthroplasty. 2012;27(5):764-9.
• 22. Jolles BM, Zangger P, Leyvraz PF. Factors predisposing to dislocation after primary total hip arthroplasty: a multivariate analysis. J Arthroplasty. 2002;17(3):282-8.
• 23. Keswani A, Beck C, Meier KM, Fields A, Bronson MJ, Moucha CS. Day of Surgery and Surgical Start Time Affect Hospital Length of Stay After Total Hip Arthroplasty. J Arthroplasty. 2016;31(11):2426-31.