Transverse Acetabular Ligament as An Anatomical Landmark for Intraoperative Cup Anteversion in Primary Total Hip Replacement. | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2017]

Author(s):

1. Mohammed Hatem Salal: Department of Orthopedic Surgery, College of Medicine, University of Baghdad, Medical City Teaching Directorate, Baghdad, Iraq

Abstract:

Objective: To assess the results of the use of transverse acetabular ligament (TAL) as an intraoperative indicator for acetabular cup anteversion alignment during total hip replacement. Study Design: Case series. Place and Duration of Study: The Nursing Home Hospital in Baghdad Medical City Complex, Baghdad, Iraq, from October 2014 to June 2015. Methodology: Patients were operated through a posterolateral approach for primary total hip arthroplasty (THA) in which transverse acetabular ligament (TAL) was identified and used as indicator for cup anteversion. Those with previous surgery and secondary osteoarthritis due to dysplasia or tumor were excluded. Postoperative anteversion angles were measured by using anteroposterior pelvic radiographs using Pardhan method by two different observers and the perceived quality of operative outcome was directly asked to the patient. Results: There were a total of 31 patients. The anteversion angle ranged between 5.7 - 24.40°. In addition, the calculated mean angle of 14.7 degrees for the current study sample did not obviously or significantly depart from the required optimum angle of 15 degrees defined by Lewinnek (15 ±10°, p=0.82). For the perceived quality of operative outcome, good outcome (satisfied) was expressed by two-thirds (67.7%) of study subjects after four weeks of surgery. Conclusion: Using transverse acetabular ligament as an intraoperative landmark is a simple, effective, and patientspecific method for proper cup anteversion placement in primary THA.

Page(s): 642-644

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 27, Issue: 10, Year: 2017

Keywords:

Transverse acetabular ligament Total hip arthroplasty Acetabular cup anteversion

References:

[1] ArchboldHA,MockfordB,MolloyD,McConwayJ,OgondaL,BeverlandD., 2006.The transverse acetabular ligament: an aid to orientation of the acetabular component during primary total hip replacement; a preliminary study of 1000 cases investigating postoperative stability,J Bone Joint Surgery Br 88 883 -6

[2] ArchboldHAP,SlomczykowskiM,CroneM., 2008.The relationship of the orientation of the transverse acetabular ligament and acetabular labrum to the suggested safe zone of cup positioning in total hip arthroplasty,Hip Int 18 6 -

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