TY - JOUR
T1 - Orientation of Transverse Acetabular Ligament With Reference to Anterior Pelvic Plane
AU - Deep, Kamal
AU - Prabhakara, Anjan
AU - Mohan, Diwakar
AU - Mahajan, Vivek
AU - Sameer, Mohamed
N1 - Publisher Copyright:
© 2020
PY - 2021/2
Y1 - 2021/2
N2 - Background: Transverse acetabular ligament (TAL) is a 3-dimensional structure which cannot be defined by a single plane. Therefore, we aimed at describing the orientation of different parts of TAL with respect to anterior pelvic plane (APP) and correlate it with gender, body mass index (BMI), and Lewinnek's safe zone. Methods: A total of 109 consecutive patients undergoing imageless navigated THA were prospectively studied. Computer navigation was used as the measurement tool. APP was registered for navigation. After excision of osteophytes, a trial component matching the size of unreamed acetabular cavity was aligned with acetabular rim, outer and inner margins, and middle of TAL to record cup orientation with computer tracker. Results: Ninety-nine patients (41 males and 58 females, mean BMI of 28.8kg/m2) were studied after applying exclusion criteria. Mean acetabular inclination was 55.15°, 53.00°, 47.70°, and 42.60° respectively, for acetabular rim, outer, middle, and inner margins of the TAL. Corresponding mean acetabular anteversion was 6.63°, 7.41°, 11.23° and 14.90°respectively. Overall, 17.17%, 28.28%, 47.47% and 71.71% of cup orientation corresponding to acetabular rim, outer, middle, and inner margin of TAL respectively, were within Lewinnek's safe zone. No association was established between BMI and acetabular orientation. Males had overall lesser anteversion than females. Conclusion: We describe orientation of outer, middle, and inner margins of TAL, as reference planes for TAL, in relation to APP. The anteversion differs significantly with gender. A knowledge about these will assist surgeon in component placement during THA, with inner margin of TAL providing the best chance of orientation out of the studied landmarks.
AB - Background: Transverse acetabular ligament (TAL) is a 3-dimensional structure which cannot be defined by a single plane. Therefore, we aimed at describing the orientation of different parts of TAL with respect to anterior pelvic plane (APP) and correlate it with gender, body mass index (BMI), and Lewinnek's safe zone. Methods: A total of 109 consecutive patients undergoing imageless navigated THA were prospectively studied. Computer navigation was used as the measurement tool. APP was registered for navigation. After excision of osteophytes, a trial component matching the size of unreamed acetabular cavity was aligned with acetabular rim, outer and inner margins, and middle of TAL to record cup orientation with computer tracker. Results: Ninety-nine patients (41 males and 58 females, mean BMI of 28.8kg/m2) were studied after applying exclusion criteria. Mean acetabular inclination was 55.15°, 53.00°, 47.70°, and 42.60° respectively, for acetabular rim, outer, middle, and inner margins of the TAL. Corresponding mean acetabular anteversion was 6.63°, 7.41°, 11.23° and 14.90°respectively. Overall, 17.17%, 28.28%, 47.47% and 71.71% of cup orientation corresponding to acetabular rim, outer, middle, and inner margin of TAL respectively, were within Lewinnek's safe zone. No association was established between BMI and acetabular orientation. Males had overall lesser anteversion than females. Conclusion: We describe orientation of outer, middle, and inner margins of TAL, as reference planes for TAL, in relation to APP. The anteversion differs significantly with gender. A knowledge about these will assist surgeon in component placement during THA, with inner margin of TAL providing the best chance of orientation out of the studied landmarks.
KW - Acetabular orientation
KW - Anterior pelvic plane
KW - BMI
KW - Gender
KW - Total hip arthroplasty (THA)
KW - Transverse acetabular ligament (TAL)
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U2 - 10.1016/j.artd.2020.11.018
DO - 10.1016/j.artd.2020.11.018
M3 - Article
C2 - 33521189
AN - SCOPUS:85097900056
SN - 2352-3441
VL - 7
SP - 1
EP - 6
JO - Arthroplasty Today
JF - Arthroplasty Today
ER -