Influence of kinematics of the lumbopelvic complex in hip arthroplasty dislocation: from assessment to recommendations
Introduction In total hip arthroplasty (THA), misplacement of the implant can provide instability. Adequate orientation of the acetabular cup is a challenge due to variations in inter-individual anatomy and kinematics of the pelvis in everyday life. The aim of this study was to characterize the kine...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2023-08, Vol.143 (8), p.4773-4783 |
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| description | Introduction
In total hip arthroplasty (THA), misplacement of the implant can provide instability. Adequate orientation of the acetabular cup is a challenge due to variations in inter-individual anatomy and kinematics of the pelvis in everyday life. The aim of this study was to characterize the kinematic factors influencing the risk of dislocation in order to give recommendations for optimal placement of the cup. We hypothesized that the lack of pelvic adaptation would influence the risk of prosthetic instability and motivate adapted.
Materials and methods
Eighty patients with primary unilateral THA were included in a matched case–control study. Seventy-four patients were divided into two groups: group 1 (G1) consisting of patients with postoperative THA dislocation (37 patients) and group 2 (G2), without episodes of dislocation within two years postoperatively (37 patients). In both groups, spino-pelvic parameters and cup orientation were measured in standing and sitting positions with EOS
®
X-ray imaging and compared to each other between 12 and 24 months post-operatively.
Results
No significant difference between the two groups was found for static parameters. In a sitting position, a lack of pelvic retroversion with a significant lower variation in sacral slope was observed in group 1 (8.0° ± 9.3 for G1 versus 14.7° ± 6.2 for G2,
p
|
| doi_str_mv | 10.1007/s00402-022-04722-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2771334218</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2842692480</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-5b00db44fea1a588627139e4dcc80efcf6ce9fa8fbdcff55111a2714ca27873f3</originalsourceid><addsrcrecordid>eNp9kctO3jAQha2qVbm0L9BFZakbNml9S-KwQ4gWJKRuYG05zpg_1LGDJ0Hw9hh-aBGLLjz2aL5zPNIh5Atn3zlj7Q9kTDFRMVGOakvt3pFdrqSqZMeb96_eO2QP8ZoxLnTHPpId2bS8VbLeJbdn0YcVogOaPP0zRpjsMjp87JYN0LBOfZoh3I6OujTNAe7oGOlmnKnNyyanOVhc7ukwYkiuSFM8pD6niVpEQJwgLnRJNENRl2Z4QvAT-eBtQPj8fO-Ty58nF8en1fnvX2fHR-eVk229VHXP2NAr5cFyW2vdiJbLDtTgnGbgnW8cdN5q3w_O-7rmnNuCKFeqbqWX--Rg6zvndLMCLmYa0UEINkJa0Yi2GEoluC7otzfodVpzLNsZoZVoOqE0K5TYUi4nxAzezHmcbL43nJnHVMw2FVNSMU-pmK6Ivj5br_0Ew1_JSwwFkFsAyyheQf73939sHwA8oZpt</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2842692480</pqid></control><display><type>article</type><title>Influence of kinematics of the lumbopelvic complex in hip arthroplasty dislocation: from assessment to recommendations</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Kouyoumdjian, Pascal ; Mansour, Jad ; Marouby, Stanislas ; Canovas, Francois ; Dagneaux, Louis ; Coulomb, Remy</creator><creatorcontrib>Kouyoumdjian, Pascal ; Mansour, Jad ; Marouby, Stanislas ; Canovas, Francois ; Dagneaux, Louis ; Coulomb, Remy</creatorcontrib><description>Introduction
In total hip arthroplasty (THA), misplacement of the implant can provide instability. Adequate orientation of the acetabular cup is a challenge due to variations in inter-individual anatomy and kinematics of the pelvis in everyday life. The aim of this study was to characterize the kinematic factors influencing the risk of dislocation in order to give recommendations for optimal placement of the cup. We hypothesized that the lack of pelvic adaptation would influence the risk of prosthetic instability and motivate adapted.
Materials and methods
Eighty patients with primary unilateral THA were included in a matched case–control study. Seventy-four patients were divided into two groups: group 1 (G1) consisting of patients with postoperative THA dislocation (37 patients) and group 2 (G2), without episodes of dislocation within two years postoperatively (37 patients). In both groups, spino-pelvic parameters and cup orientation were measured in standing and sitting positions with EOS
®
X-ray imaging and compared to each other between 12 and 24 months post-operatively.
Results
No significant difference between the two groups was found for static parameters. In a sitting position, a lack of pelvic retroversion with a significant lower variation in sacral slope was observed in group 1 (8.0° ± 9.3 for G1 versus 14.7° ± 6.2 for G2,
p
< 0.01). Twenty-two (59%) patients with THA instability had sacral slope variations of less than 10° versus eight (21% of patients) with stable THA (
p
< 0.01). Cup orientation in the Lewinnek safe zone was not significantly different (59% vs 67%,
p
= 0.62), and the spino-pelvic parameters and cup orientation measured did not change between the standing and sitting positions. However, only 14 (37%) cups in G1 were in the functional safe zone versus 24 (67%) in G2 (
p
= 0.03).
Conclusion
Static parameters of the sagittal spinopelvic balance have a low predictive value for prosthetic instability. Dynamic analysis is essential. Kinematic parameters must be taken into account in determining the ideal position of the cup or stem. Stiffness with locked standing or sitting pelvis must be integrated in order to determine a personalized safe zone.
Level of evidence
Level III (matched case–control study).</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-022-04722-9</identifier><identifier>PMID: 36717435</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Acetabulum - surgery ; Arthroplasty, Replacement, Hip - methods ; Biomechanical Phenomena ; Case-Control Studies ; Humans ; Joint Dislocations - surgery ; Joint surgery ; Kinematics ; Medicine ; Medicine & Public Health ; Orthopaedic Surgery ; Orthopedics ; Pelvis ; Pelvis - surgery ; Prostheses ; Retrospective Studies</subject><ispartof>Archives of orthopaedic and trauma surgery, 2023-08, Vol.143 (8), p.4773-4783</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-5b00db44fea1a588627139e4dcc80efcf6ce9fa8fbdcff55111a2714ca27873f3</citedby><cites>FETCH-LOGICAL-c375t-5b00db44fea1a588627139e4dcc80efcf6ce9fa8fbdcff55111a2714ca27873f3</cites><orcidid>0000-0002-0717-9600</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-022-04722-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-022-04722-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36717435$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kouyoumdjian, Pascal</creatorcontrib><creatorcontrib>Mansour, Jad</creatorcontrib><creatorcontrib>Marouby, Stanislas</creatorcontrib><creatorcontrib>Canovas, Francois</creatorcontrib><creatorcontrib>Dagneaux, Louis</creatorcontrib><creatorcontrib>Coulomb, Remy</creatorcontrib><title>Influence of kinematics of the lumbopelvic complex in hip arthroplasty dislocation: from assessment to recommendations</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
In total hip arthroplasty (THA), misplacement of the implant can provide instability. Adequate orientation of the acetabular cup is a challenge due to variations in inter-individual anatomy and kinematics of the pelvis in everyday life. The aim of this study was to characterize the kinematic factors influencing the risk of dislocation in order to give recommendations for optimal placement of the cup. We hypothesized that the lack of pelvic adaptation would influence the risk of prosthetic instability and motivate adapted.
Materials and methods
Eighty patients with primary unilateral THA were included in a matched case–control study. Seventy-four patients were divided into two groups: group 1 (G1) consisting of patients with postoperative THA dislocation (37 patients) and group 2 (G2), without episodes of dislocation within two years postoperatively (37 patients). In both groups, spino-pelvic parameters and cup orientation were measured in standing and sitting positions with EOS
®
X-ray imaging and compared to each other between 12 and 24 months post-operatively.
Results
No significant difference between the two groups was found for static parameters. In a sitting position, a lack of pelvic retroversion with a significant lower variation in sacral slope was observed in group 1 (8.0° ± 9.3 for G1 versus 14.7° ± 6.2 for G2,
p
< 0.01). Twenty-two (59%) patients with THA instability had sacral slope variations of less than 10° versus eight (21% of patients) with stable THA (
p
< 0.01). Cup orientation in the Lewinnek safe zone was not significantly different (59% vs 67%,
p
= 0.62), and the spino-pelvic parameters and cup orientation measured did not change between the standing and sitting positions. However, only 14 (37%) cups in G1 were in the functional safe zone versus 24 (67%) in G2 (
p
= 0.03).
Conclusion
Static parameters of the sagittal spinopelvic balance have a low predictive value for prosthetic instability. Dynamic analysis is essential. Kinematic parameters must be taken into account in determining the ideal position of the cup or stem. Stiffness with locked standing or sitting pelvis must be integrated in order to determine a personalized safe zone.
Level of evidence
Level III (matched case–control study).</description><subject>Acetabulum - surgery</subject><subject>Arthroplasty, Replacement, Hip - methods</subject><subject>Biomechanical Phenomena</subject><subject>Case-Control Studies</subject><subject>Humans</subject><subject>Joint Dislocations - surgery</subject><subject>Joint surgery</subject><subject>Kinematics</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopaedic Surgery</subject><subject>Orthopedics</subject><subject>Pelvis</subject><subject>Pelvis - surgery</subject><subject>Prostheses</subject><subject>Retrospective Studies</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kctO3jAQha2qVbm0L9BFZakbNml9S-KwQ4gWJKRuYG05zpg_1LGDJ0Hw9hh-aBGLLjz2aL5zPNIh5Atn3zlj7Q9kTDFRMVGOakvt3pFdrqSqZMeb96_eO2QP8ZoxLnTHPpId2bS8VbLeJbdn0YcVogOaPP0zRpjsMjp87JYN0LBOfZoh3I6OujTNAe7oGOlmnKnNyyanOVhc7ukwYkiuSFM8pD6niVpEQJwgLnRJNENRl2Z4QvAT-eBtQPj8fO-Ty58nF8en1fnvX2fHR-eVk229VHXP2NAr5cFyW2vdiJbLDtTgnGbgnW8cdN5q3w_O-7rmnNuCKFeqbqWX--Rg6zvndLMCLmYa0UEINkJa0Yi2GEoluC7otzfodVpzLNsZoZVoOqE0K5TYUi4nxAzezHmcbL43nJnHVMw2FVNSMU-pmK6Ivj5br_0Ew1_JSwwFkFsAyyheQf73939sHwA8oZpt</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Kouyoumdjian, Pascal</creator><creator>Mansour, Jad</creator><creator>Marouby, Stanislas</creator><creator>Canovas, Francois</creator><creator>Dagneaux, Louis</creator><creator>Coulomb, Remy</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0717-9600</orcidid></search><sort><creationdate>20230801</creationdate><title>Influence of kinematics of the lumbopelvic complex in hip arthroplasty dislocation: from assessment to recommendations</title><author>Kouyoumdjian, Pascal ; Mansour, Jad ; Marouby, Stanislas ; Canovas, Francois ; Dagneaux, Louis ; Coulomb, Remy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-5b00db44fea1a588627139e4dcc80efcf6ce9fa8fbdcff55111a2714ca27873f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Acetabulum - surgery</topic><topic>Arthroplasty, Replacement, Hip - methods</topic><topic>Biomechanical Phenomena</topic><topic>Case-Control Studies</topic><topic>Humans</topic><topic>Joint Dislocations - surgery</topic><topic>Joint surgery</topic><topic>Kinematics</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopaedic Surgery</topic><topic>Orthopedics</topic><topic>Pelvis</topic><topic>Pelvis - surgery</topic><topic>Prostheses</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kouyoumdjian, Pascal</creatorcontrib><creatorcontrib>Mansour, Jad</creatorcontrib><creatorcontrib>Marouby, Stanislas</creatorcontrib><creatorcontrib>Canovas, Francois</creatorcontrib><creatorcontrib>Dagneaux, Louis</creatorcontrib><creatorcontrib>Coulomb, Remy</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kouyoumdjian, Pascal</au><au>Mansour, Jad</au><au>Marouby, Stanislas</au><au>Canovas, Francois</au><au>Dagneaux, Louis</au><au>Coulomb, Remy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of kinematics of the lumbopelvic complex in hip arthroplasty dislocation: from assessment to recommendations</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>143</volume><issue>8</issue><spage>4773</spage><epage>4783</epage><pages>4773-4783</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
In total hip arthroplasty (THA), misplacement of the implant can provide instability. Adequate orientation of the acetabular cup is a challenge due to variations in inter-individual anatomy and kinematics of the pelvis in everyday life. The aim of this study was to characterize the kinematic factors influencing the risk of dislocation in order to give recommendations for optimal placement of the cup. We hypothesized that the lack of pelvic adaptation would influence the risk of prosthetic instability and motivate adapted.
Materials and methods
Eighty patients with primary unilateral THA were included in a matched case–control study. Seventy-four patients were divided into two groups: group 1 (G1) consisting of patients with postoperative THA dislocation (37 patients) and group 2 (G2), without episodes of dislocation within two years postoperatively (37 patients). In both groups, spino-pelvic parameters and cup orientation were measured in standing and sitting positions with EOS
®
X-ray imaging and compared to each other between 12 and 24 months post-operatively.
Results
No significant difference between the two groups was found for static parameters. In a sitting position, a lack of pelvic retroversion with a significant lower variation in sacral slope was observed in group 1 (8.0° ± 9.3 for G1 versus 14.7° ± 6.2 for G2,
p
< 0.01). Twenty-two (59%) patients with THA instability had sacral slope variations of less than 10° versus eight (21% of patients) with stable THA (
p
< 0.01). Cup orientation in the Lewinnek safe zone was not significantly different (59% vs 67%,
p
= 0.62), and the spino-pelvic parameters and cup orientation measured did not change between the standing and sitting positions. However, only 14 (37%) cups in G1 were in the functional safe zone versus 24 (67%) in G2 (
p
= 0.03).
Conclusion
Static parameters of the sagittal spinopelvic balance have a low predictive value for prosthetic instability. Dynamic analysis is essential. Kinematic parameters must be taken into account in determining the ideal position of the cup or stem. Stiffness with locked standing or sitting pelvis must be integrated in order to determine a personalized safe zone.
Level of evidence
Level III (matched case–control study).</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36717435</pmid><doi>10.1007/s00402-022-04722-9</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-0717-9600</orcidid></addata></record> |
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| ispartof | Archives of orthopaedic and trauma surgery, 2023-08, Vol.143 (8), p.4773-4783 |
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| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Acetabulum - surgery Arthroplasty, Replacement, Hip - methods Biomechanical Phenomena Case-Control Studies Humans Joint Dislocations - surgery Joint surgery Kinematics Medicine Medicine & Public Health Orthopaedic Surgery Orthopedics Pelvis Pelvis - surgery Prostheses Retrospective Studies |
| title | Influence of kinematics of the lumbopelvic complex in hip arthroplasty dislocation: from assessment to recommendations |
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