title: Acetabular Dysplasia and Surgical Approaches Other Than Direct Anterior Increases Risk for Malpositioning of the Acetabular Component in Total Hip Arthroplasty.
abstract: BACKGROUND
  Persistent acetabular dysplasia (AD) after periacetabular osteotomy has been hypothesized to increase the risk for malpositioning of the acetabular component. In this study, we investigate whether AD is an independent risk factor for cup malpositioning during primary total hip arthroplasty (THA).
  
  
  METHODS
  Patient demographics, surgical approach, presence of AD assessed using the lateral center-edge angle, and acetabular cup positioning determined using Martell Hip Analysis Suite were investigated in 836 primary THA patients enrolled in a prospective multicenter study.
  
  
  RESULTS
  We found that presence of AD, defined as the lateral center-edge angle of <25°, is an independent risk factor for malpositioning of the acetabular component during primary THA. Surgical approach other than direct anterior was also independently associated with malpositioned cups.
  
  
  CONCLUSIONS
  Surgeons should therefore take special care during placement of the acetabular component in patients with AD.
authors.affiliation: Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts; Department of Orthopaedic Surgery, Copenhagen Hospital, Hvidovre, Copenhagen, Denmark.
authors.forename: Kirill
authors.initials: K
authors.lastname: Gromov
authors.affiliation: Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Meridith E
authors.initials: ME
authors.lastname: Greene
authors.affiliation: Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California.
authors.forename: James I
authors.initials: JI
authors.lastname: Huddleston
authors.affiliation: Texas center for Joint Replacement, Plano, Texas.
authors.forename: Roger
authors.initials: R
authors.lastname: Emerson
authors.affiliation: Department of Orthopaedic Surgery, Copenhagen Hospital, Hvidovre, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Gebuhr
authors.affiliation: Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Henrik
authors.initials: H
authors.lastname: Malchau
authors.affiliation: Department of Orthopaedic Surgery, Copenhagen Hospital, Hvidovre, Copenhagen, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Troelsen
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006617:Hip Dislocation / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D011446:Prospective Studies; D012307:Risk Factors
keywords: Martell analysis; anteversion; component positioning; dysplasia; total hip arthroplasty