Measurements of pelvic flexion angle using three-dimensional computed tomography. 2003

Shunsaku Nishihara, and Nobuhiko Sugano, and Takashi Nishii, and Kenji Ohzono, and Hideki Yoshikawa
Department of Orthopaedic Surgery, Osaka University Medical School, Japan. shu-nishihara@umin.ac.jp

The purpose of the current study was to evaluate whether safe acetabular component position depends on differences in pelvic location between the supine, standing, and sitting positions. The subjects of the current study were 101 patients who had total hip arthroplasty. Anteroposterior radiographs of the pelvis with the patients in the supine, standing, and sitting positions were obtained preoperatively and 1 year after total hip arthroplasty. Computed tomography images of the pelvis were obtained preoperatively. Using image matching between the three-dimensional computed tomography model and anteroposterior radiograph, pelvic flexion angles with the patient in the supine, standing, and sitting positions were calculated. The mean preoperative pelvic flexion angle was 5 degrees +/- 9 degrees (range, -37 degrees -30 degrees ) in the supine position, 3 degrees +/- 12 degrees (range, -46 degrees -33 degrees ) in the standing position, and -29 degrees +/- 12 degrees (range, -62 degrees -10 degrees ) in the sitting position. Because there was much intersubject variability in pelvic flexion angle, it is not appropriate to determine orientation of the acetabular component from anatomic landmarks. In 90% of the cases, the difference in pelvic flexion angle between the supine and standing positions preoperatively was 10 degrees or less. In 90% of the cases, there was 20 degrees or greater extension of the pelvis from the supine position to the sitting position preoperatively, and the safe range of flexion of the hip from anterior prosthetic impingement in the sitting position was 20 degrees or greater than that in the supine position. Preoperative pelvic position in each case was almost completely maintained 1 year after total hip arthroplasty. It is reasonable to regard the pelvic position in the supine position as the functional pelvic position and proper pelvic reference frame in determining optimal orientation of the acetabular component in 90% of cases before and 1 year after total hip arthroplasty, although an adjustment of orientation of the acetabular component was needed for the remaining cases.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010384 Pelvic Bones Bones that constitute each half of the pelvic girdle in VERTEBRATES, formed by fusion of the ILIUM; ISCHIUM; and PUBIC BONE. Coxal Bone,Hip Bone,Innominate Bones,Bone, Coxal,Bone, Hip,Bone, Innominate,Bone, Pelvic,Bones, Coxal,Bones, Hip,Bones, Innominate,Bones, Pelvic,Coxal Bones,Hip Bones,Innominate Bone,Pelvic Bone
D011187 Posture The position or physical attitude of the body. Postures
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077 Acetabulum The part of the pelvis that comprises the pelvic socket where the head of FEMUR joins to form HIP JOINT (acetabulofemoral joint). Acetabula,Cotyloid Cavity,Acetabulas,Acetabulums,Cavities, Cotyloid,Cavity, Cotyloid,Cotyloid Cavities
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old

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