title: Research synthesis of recommended acetabular cup orientations for total hip arthroplasty.
abstract: Total hip arthroplasty (THA) is regarded as one of the most successful surgical procedures of modern times yet continues to be associated with a small but significant complication rate. Many early failures may be associated with poor component positioning with, in particular, acetabular component orientation dependent on the subjective judgement of the surgeon. In this paper, we compare the manufacturers' instructions on acetabular cup orientation with the literature-based recommended safety zones and surgical technique, by transforming them onto a single, clinically-relevant framework in which the different reference systems, safety guidelines and current instrumentation surgical techniques can be evaluated. The observed limited consensus between results reflects ongoing uncertainty regarding the optimum acetabular component positioning. As malpositioning of the acetabular cup increases the risk of revision surgery, any ambiguity over the correct position can have a causal effect. Our analysis highlights the need for a surgical reference system which can be used to describe the position of the acetabular cup intra-operatively.
authors: Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK.
authors: Claire L
authors: CL
authors: Harrison
authors: Department of Design Manufacture and Engineering Management, University of Strathclyde, Glasgow, UK.
authors: Avril I
authors: AI
authors: Thomson
authors: James Paget University Hospital, Great Yarmouth, UK.
authors: Steven
authors: S
authors: Cutts
authors: Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK.
authors: Philip J
authors: PJ
authors: Rowe
authors: Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK.
authors: Philip E
authors: PE
authors: Riches
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D006622:Hip Prosthesis; D006801:Humans; D012042:Registries
keywords: acetabular cup; correct orientation; malpositioning; total hip arthroplasty