Changes in acetabular component alignment due to screw fixation in patients with hip dysplasia

Tomonori Tetsunaga, Kazuo Fujiwara, Hirosuke Endo, Tomoko Tetsunaga, Takamasa Miyake, Kazuki Yamada, Tomoaki Sanki, Toshifumi Ozaki

Research output: Contribution to journalArticle

Abstract

Introduction: Adequate initial stability of the acetabular cup is essential for total hip arthroplasty (THA). However, changes in the alignment of the acetabular component caused by screw fixation are concerning in patients with inadequate bone stock. This study aimed to investigate the effects of screw fixation on the alignment of the acetabular component in THA patients with hip dysplasia. Methods: We retrospectively examined 256 hips (range 28–87 years) that underwent THA using a navigation system. Patients were divided into 2 groups based on the presence or absence of changes in the alignment of the intraoperative acetabular cup, and univariate and multivariate analyses were performed to identify factors that were predictive of changes in acetabular component alignment after screw fixation in 2 dimensions: inclination and anteversion. Results: Screw fixation led to a mean change in inclination of 1.6° (range 0–10°) and a mean change in anteversion of 1.4° (range 0–14°). The Crowe classification, the presence of bone cysts, and the use of an inferior quadrant screw were identified as factors that correlated with acetabular cup alignment changes in inclination (odds ratios, 6.01, 5.94 and 0.03, respectively). Only the Crowe classification was identified as a factor that correlated with intraoperative alignment changes in anteversion (odds ratio, 2.08). Conclusions: Screw fixation altered the acetabular cup alignment. The inclination changes were related to the extent of the dysplasia, and the risk was reduced when the inferior quadrant screw was used. Surgeons should use caution during screw fixation in THAs performed on severely dysplastic hips.

Original languageEnglish
JournalHIP International
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Hip Dislocation
Hip
Arthroplasty
Odds Ratio
Bone Cysts
Tacrine
Multivariate Analysis
Bone and Bones

Keywords

  • Anteversion
  • inclination
  • navigation system
  • screw
  • total hip arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Changes in acetabular component alignment due to screw fixation in patients with hip dysplasia. / Tetsunaga, Tomonori; Fujiwara, Kazuo; Endo, Hirosuke; Tetsunaga, Tomoko; Miyake, Takamasa; Yamada, Kazuki; Sanki, Tomoaki; Ozaki, Toshifumi.

In: HIP International, 01.01.2019.

Research output: Contribution to journalArticle

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AU - Fujiwara, Kazuo

AU - Endo, Hirosuke

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AU - Miyake, Takamasa

AU - Yamada, Kazuki

AU - Sanki, Tomoaki

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N2 - Introduction: Adequate initial stability of the acetabular cup is essential for total hip arthroplasty (THA). However, changes in the alignment of the acetabular component caused by screw fixation are concerning in patients with inadequate bone stock. This study aimed to investigate the effects of screw fixation on the alignment of the acetabular component in THA patients with hip dysplasia. Methods: We retrospectively examined 256 hips (range 28–87 years) that underwent THA using a navigation system. Patients were divided into 2 groups based on the presence or absence of changes in the alignment of the intraoperative acetabular cup, and univariate and multivariate analyses were performed to identify factors that were predictive of changes in acetabular component alignment after screw fixation in 2 dimensions: inclination and anteversion. Results: Screw fixation led to a mean change in inclination of 1.6° (range 0–10°) and a mean change in anteversion of 1.4° (range 0–14°). The Crowe classification, the presence of bone cysts, and the use of an inferior quadrant screw were identified as factors that correlated with acetabular cup alignment changes in inclination (odds ratios, 6.01, 5.94 and 0.03, respectively). Only the Crowe classification was identified as a factor that correlated with intraoperative alignment changes in anteversion (odds ratio, 2.08). Conclusions: Screw fixation altered the acetabular cup alignment. The inclination changes were related to the extent of the dysplasia, and the risk was reduced when the inferior quadrant screw was used. Surgeons should use caution during screw fixation in THAs performed on severely dysplastic hips.

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