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Accuracy of intraoperative approximation of pelvic tilt using preoperative standing radiographs.
Accuracy of intraoperative approximation of pelvic tilt using preoperative standing radiographs.
- Source :
- Journal of Orthopaedics; Aug2024, Vol. 54, p120-123, 4p
- Publication Year :
- 2024
-
Abstract
- Anterior approach surgeons who utilize intraoperative fluoroscopy often try to match a preoperative radiograph as a reference for intraoperative cup position. Every degree of inaccuracy in tilt leads to a roughly 0.7° change in anteversion. This study aimed to determine how closely pelvic tilt (PT) is approximated intraoperatively when compared to preoperative anteroposterior (AP) radiographs. This was a retrospective review of 193 primary THA's done by 2 surgeons at an academic tertiary referral center between September 2021–January 2023. There were 24 patients excluded for distorted anatomy, post-traumatic arthritis, insufficient x-rays, or a sacroiliac joint that could not be visualized on film. Data collected included age and BMI. PT was calculated using the formula, Tilt = -(ln((B/A) x (1/0.483)))/0.051. Value A is the distance from the base of the SI joint to the superior margin of the obturator foramen; value B is the height of the obturator foramen. Mean preoperative PT was 0.2° versus intraoperative PT was 3.4° (p < 0.001). Mean absolute difference was 6.5°. 48% of patients (n = 81) had an absolute difference less than 5°, 31% (n = 52) between 5° and 10°, 14% (n = 24) between 10° and 15°, and 7% (n = 12) greater than 15°. There was no correlation between BMI or age and PT discrepancy. Of the patients, 21% had a discrepancy of 10° or greater between their preoperative radiographs and intraoperative fluoroscopic images. Surgeons should be aware of potential errors in cup positioning and be particularly diligent in high-risk cases. [ABSTRACT FROM AUTHOR]
- Subjects :
- PELVIC radiography
PREVENTION of medical errors
RADIOGRAPHY
PELVIS
SURGERY
PATIENTS
TOTAL hip replacement
ACADEMIC medical centers
MEDICAL errors
STANDING position
PREOPERATIVE care
RETROSPECTIVE studies
TERTIARY care
DESCRIPTIVE statistics
INTRAOPERATIVE monitoring
MEDICAL records
ACQUISITION of data
BODY movement
COMPARATIVE studies
Subjects
Details
- Language :
- English
- ISSN :
- 25899082
- Volume :
- 54
- Database :
- Complementary Index
- Journal :
- Journal of Orthopaedics
- Publication Type :
- Academic Journal
- Accession number :
- 178045112
- Full Text :
- https://doi.org/10.1016/j.jor.2024.03.026