Back to Search Start Over

Accuracy of intraoperative approximation of pelvic tilt using preoperative standing radiographs.

Accuracy of intraoperative approximation of pelvic tilt using preoperative standing radiographs.

Authors :
Oetojo, William
Lawler, Patrick
Farooq, Hassan
Pierrepont, Jim
Schmitt, Daniel
Brown, Nicholas
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]

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