Danish survey of acetabular component positioning practice during primary total hip arthroplasty

TY - JOUR

T1 - Danish survey of acetabular component positioning practice during primary total hip arthroplasty

AU - Cotong, Dana

AU - Troelsen, Anders

AU - Husted, Henrik

AU - Gromov, Kirill

N1 - Articles published in the Danish Medical Journal are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

PY - 2017/4

Y1 - 2017/4

N2 - INTRODUCTION: The Lewinnek and Callanan “safe zones” have been widely used to minimise the dislocation frequency in total hip arthroplasty (THA), but recent studies have questioned the association between “safe zones” and lower dislocation rates. The purpose of this study was to investigate: 1) if hip surgeons agree on a specific “safe zone” for cup positioning and 2) surgeons’ surgical practice patterns regarding recurring instability in primary THA. METHODS: A survey was performed among hip surgeons during the 2015 Annual Meeting of the Danish Orthopaedic Society. The survey contained questions on optimal component positioning, surgical practice patterns in primary THA, indications and surgical techniques used in revision THA. RESULTS: A total of 42 questionnaires were collected, two were excluded, leaving 40 for analyses. 97% of the surgeons reported an optimum cup anteversion within the Lewinnek and Callanan “safe zones”, whereas 97% and 83% reported optimum cup inclination within the Lewinnek and Callanan “safe zones”, respectively. The reported range for optimal cup positioning varied from 30-55 degrees of inclination and 15-30 degrees of anteversion. The minimum and maximum accepted cup inclination and anteversion within the Lewinnek “safe zone” was 68% and 67%, respectively. CONCLUSIONS: Hip surgeons agree that optimum cup positioning should lie within the Lewinnek “safe zone”, but they do not agree on the exact optimal cup positioning with respect to inclination and anteversion. This is in accordance with current evidence that strict usage of the Lewinnek “safe zone” cannot be justified.

AB - INTRODUCTION: The Lewinnek and Callanan “safe zones” have been widely used to minimise the dislocation frequency in total hip arthroplasty (THA), but recent studies have questioned the association between “safe zones” and lower dislocation rates. The purpose of this study was to investigate: 1) if hip surgeons agree on a specific “safe zone” for cup positioning and 2) surgeons’ surgical practice patterns regarding recurring instability in primary THA. METHODS: A survey was performed among hip surgeons during the 2015 Annual Meeting of the Danish Orthopaedic Society. The survey contained questions on optimal component positioning, surgical practice patterns in primary THA, indications and surgical techniques used in revision THA. RESULTS: A total of 42 questionnaires were collected, two were excluded, leaving 40 for analyses. 97% of the surgeons reported an optimum cup anteversion within the Lewinnek and Callanan “safe zones”, whereas 97% and 83% reported optimum cup inclination within the Lewinnek and Callanan “safe zones”, respectively. The reported range for optimal cup positioning varied from 30-55 degrees of inclination and 15-30 degrees of anteversion. The minimum and maximum accepted cup inclination and anteversion within the Lewinnek “safe zone” was 68% and 67%, respectively. CONCLUSIONS: Hip surgeons agree that optimum cup positioning should lie within the Lewinnek “safe zone”, but they do not agree on the exact optimal cup positioning with respect to inclination and anteversion. This is in accordance with current evidence that strict usage of the Lewinnek “safe zone” cannot be justified.

KW - Acetabulum/diagnostic imaging

KW - Arthroplasty, Replacement, Hip/methods

KW - Hip Prosthesis/standards

KW - Humans

KW - Practice Patterns, Physicians'

KW - Radiography

KW - Surveys and Questionnaires

M3 - Journal article

C2 - 28385170

SN - 2245-1919

VL - 64

JO - Danish Medical Journal

JF - Danish Medical Journal

IS - 4

M1 - A5354

ER -