Preoperative spinal sagittal deformity impacts this change. Conclusion: Spinopelvic alignment changes after THA, evident by a reduction in SVA. There was no significant impact of contralateral hip OA, PI, or age on change in alignment parameters. High TPA patients significantly decreased SVA more than low TPA patients. Preoperative TPA was significantly associated with the change in PI-LL, SVA, and TPA. Overall, the following significant changes were found from pre-to postoperative: SPT (14.2 vs. Follow-up radiographs were performed at mean 220 days. Results: 95 patients were included (mean age 58.6 yrs, BMI 28.7 kg/m2, 48.2% F). Similarly, the influence of K-L grade, age, and PI were also tested.
Patients were separated into low and high TPA (/=20 deg) and change in parameters were compared between groups by t-test. Linear regression was performed to assess the impact of preoperative TPA and changes in spinal alignment. The severity of preoperative thoracolumbar deformity was measured using TPA. Pre-and postoperative alignment parameters were compared by paired t-test. Contralateral hip was graded on the Kellgren-Lawrence scale. Standing spinopelvic parameters were measured. Methods: In this retrospective cohort study, patients undergoing THA for OA with pre-and postoperative full-body radiographs were included. The purpose of this study was to assess the influence of total hip arthroplasty (THA) on standing spinopelvic alignment. Objectives: The interactions between hip osteoarthritis (OA) and spinal malalignment are poorly understood. on behalf of The American Association of Hip and Knee Surgeons.Study Design: Retrospective cohort study. This warrants further investigation into a consistent application of the term and its implications for THA implant stability and dislocation rates.Īnterior pelvic plane Anteversion Inclination Lewinnek Safe zone Total hip arthroplasty.
In the discussion of the safe zone regarding THA, only 11% of articles listed are consistent with the definition established by Lewinnek. Twenty-three percent (34) measured from computed tomography scans instead of other methods. Nineteen percent (28) reported measurements of the acetabular cup orthogonal to the anterior pelvic plane, while 73% (108) did not, and 7% (11) did not specify. Forty-five percent (66) of articles referenced measurements in the supine position, 18% (26) referenced other positions, and 37% (55) did not specify. Overall, only 11% (17) cited the Lewinnek article correctly.
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Search criteria included terms 'Lewinnek,' 'safe zone,' and 'total hip arthroplasty.' Exclusions included abstract-only articles, non-English articles, articles unrelated to THA, and those lacking full content.Ī review of literature yielded 147 articles for inclusion. Therefore, this article aims to examine the available literature in the PubMed database to determine how often a correct reference to the safe zone as defined by Lewinnek was applied to discussions regarding THA.Ī search for literature in the PubMed database was performed for articles from 1978 to 2019. Although there has been considerable debate in the literature concerning the safe zone, to date, there has not been any review to determine if these references are consistent with the definition applied by Lewinnek et al. Optimal acetabular component orientation in total hip arthroplasty (THA) is a necessity in achieving a stable implant.
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