Cup inclination is a major factor in the success of a total hip replacement. An open cup position can lead to dislocation or increased wear from rim loading and a closed cup position lead to impingement against the femoral neck or psoas. Although the ideal inclination for cup position is recommended as between 40 and 45 degrees, accurate positioning of the implant might be influenced by pelvic flexion and movement of the patient's pelvis during the procedure. We wanted to examine if the transvers acetabular ligament (TAL) could be used to determine cup inclination intra-operatively. 16 hips from 9 cadaveric specimens were used for the study. A computer navigation system (Brain lab) was used to measure and document the exact inclination and version of the acetabular trial component in three positions: flush with the transvers acetabular ligament (TAL), with the rim of the cup 5 mm from the TAL in a cranial direction and with the rim of the cup 5 mm caudally displaced. Statistical analysis of the results was performed by the Department of Biostatistics.Background
Methods