Spinopelvic alignment and precise cup placement in total hip arthroplasty - A systematic review

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2024-08-14 DOI:10.1016/j.jor.2024.08.008

S. Ram Sudhan , Sibin Surendran , Naveen P. Gopinath , Jijulal C U , V.V. Muhammed Fazil , P. Gopinathan , K.V. Nikhil

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引用次数: 0

Abstract

Study Design

A systematic literature review and meta- analysis

Objective

To extract and combine the available literature focused on normal and abnormal biomechanical principles of spine-pelvis-hip complex and to sum up the data in the application of THA both in the setting with and without spinal disorders.

Methods

An extensive search and analysis of the articles was done by 3 authors independently in 7 platforms based on PRISMA and MOOSE guidelines. Selection criteria 1. Articles that assessed spinopelvic parameters (SS, SPT, PI, and acetabular cup orientation) in patients undergoing THA, Articles that assessed balance in spinopelvic complex after THA, Randomized control studies, Systematic literature reviews, Meta-analyses, Clinical trials / original research studies, Review articles and Articles after 2015 were included. Cochrane’s GRADE method was used to define the level of evidence. 2.Participants: Patients who underwent THA only (in asymptomatic spine), those who had ankylosing spondylitis and underwent THA and those who underwent THA with prior spinal arthrodesis. 3.Study parameters: Ante Inclination (AI), sacral slope (SS), pelvic Incidence (PI) and spinopelvic tilt (SPT) in both positions of standing and sitting. ΔAI, ΔSS and ΔSPT. Data were collected and analyzed, the means of the study parameters with SD were calculated and a meta-analysis is performed to evaluate the pooled means with optimal value range.

Results

From 218 abstracts extracted and after eligibility assessment and exclusion, 4 articles involving 439 patients were enrolled. The mean SS in standing and sitting calculated were 35.53±10.52 and 33.13±12.38. The mean of AI and SPT in standing /sitting positions are 29.7±12.29/34.69±12.96 (n = 242) and 19.56±8.9/21.22±12.53 (n=439) respectively. The ΔAI, ΔSS, and ΔSPT were 4.99,2.4 and 1.66 respectively.

Conclusion

There is a proportionate change between the spinopelvic tilt and the acetabular orientation in postural variations. Evaluation of spine, pelvis and hip becomes more critical in identifying these changes and thereby prompting the acetabular cup position in the functional safe zone.

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全髋关节置换术中的骨盆对齐和精确置杯--系统性综述

研究设计系统性文献综述和荟萃分析目的提取并整合现有文献，重点关注脊柱-骨盆-髋关节复合体的正常和异常生物力学原理，并总结在有脊柱疾病和无脊柱疾病情况下应用 THA 的数据。筛选标准 1.纳入评估接受 THA 患者脊柱骨盆参数（SS、SPT、PI 和髋臼杯方向）的文章、评估 THA 后脊柱骨盆复合体平衡的文章、随机对照研究、系统文献综述、Meta 分析、临床试验/原始研究、综述文章和 2015 年后的文章。采用 Cochrane 的 GRADE 方法确定证据等级。2.参与者仅接受 THA 的患者（无症状脊柱）、患有强直性脊柱炎并接受 THA 的患者以及接受过脊柱关节置换术的患者。3.研究参数：站姿和坐姿下的前倾（AI）、骶骨斜度（SS）、骨盆入射角（PI）和脊柱骨盆倾斜（SPT）。ΔAI、ΔSS 和 ΔSPT。收集并分析数据，计算研究参数的平均值和标清值，并进行荟萃分析，以评估具有最佳值范围的集合平均值。结果从提取的 218 篇摘要中，经资格评估和排除后，共纳入 4 篇文章，涉及 439 名患者。计算得出的站立和坐姿的平均 SS 值分别为 35.53±10.52 和 33.13±12.38。站姿/坐姿的 AI 和 SPT 平均值分别为 29.7±12.29/34.69±12.96 （n=242）和 19.56±8.9/21.22±12.53 （n=439）。ΔAI、ΔSS 和 ΔSPT 分别为 4.99、2.4 和 1.66。对脊柱、骨盆和髋关节的评估对于识别这些变化，从而将髋臼杯的位置调整到功能安全区变得更加重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.