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. 2018 May 23;13(1):123.
doi: 10.1186/s13018-018-0789-y.

Is the cup orientation different in bilateral total hip arthroplasty with right-handed surgeons using posterolateral approach?

Xinggui Song  1   2 , Ming Ni  1 , Heng Li  1 , Xin Li  1 , Xiang Li  1 , Jun Fu  1 , Jiying Chen  3
Affiliations

Is the cup orientation different in bilateral total hip arthroplasty with right-handed surgeons using posterolateral approach?

Xinggui Song et al. J Orthop Surg Res. .

Abstract

Background: The impact of surgeon handedness on acetabular cup orientation in total hip arthroplasty (THA) is not well studied. The aim of our study is to investigate the difference of cup orientation in bilateral THA performed by right-handed surgeons using posterolateral approach and which cup could be fitter to Lewinneck's safe zone.

Methods: The study consisted of 498 patients that underwent bilateral THA by three right-handed surgeons in our hospital. Postoperative acetabular cup anteversion and abduction on an anteroposterior pelvic radiograph were measured by Orthoview software (Orthoview LLC, Jacksonville, Florida). Furthermore, the percentage of cup placement within the safe zone was compared.

Results: The mean anteversion was 25.28 (25.28° ± 7.16°) in left THA and 22.01 (22.01° ± 6.35°) in right THA (p < 0.001). The mean abduction was 37.50 (37.50° ± 6.76°) in left THA and 38.59 (38.59° ± 6.84°) in right THA (p = 0.011). In the left side, the cup was positioned in Lewinnek's safe zone in 52% for anteversion, 87% for abduction, and 46% for both anteversion and abduction. But the cup placement within Lewinnek's safe zone was 71, 88, and 62% in the right side, respectively. There were significant differences in the percentage of acetabular cup placement within the safe zone for anteversion (p < 0.001) and for both anteversion and inclination (p < 0.001). Dislocation occurred in 7.0% (35/498) of cases in left THA and 3.2% (16/498) in right THA. The percentages of patients experiencing dislocation were significantly different between the two sides (p = 0.006).

Conclusions: This current study demonstrated that surgeon handedness is likely to be a contributing factor that affects cup inclination and anteversion in bilateral THA and that the placement of cup performed by dominant hands of surgeons is more accurate than that performed by non-dominant sides.

Keywords: Anteversion; Inclination; Safe zone; Surgeon handedness; Total hip arthroplasty.

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Conflict of interest statement

Ethics approval and consent to participate

The Ethics Committee of Chinese PLA General Hospital reviewed and approved this study, and written informed consent was obtained from the patients for the publication of individual clinical details and accompanying images. The study was conducted according to the ethical principles stated in the Declaration of Helsinki.

Consent for publication

We obtained permission from patients/participants to publish their data, and all authors consent for publication.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Method for measuring acetabular anteversion and inclination on an AP pelvic radiography using the Orthoview Digital Planning Software system
Fig. 2
Fig. 2
The percentage of safe zone placement for inclination, anteversion, and both for left and right THA in surgeon A, B, C, and all patients
Fig. 3
Fig. 3
Mean acetabular inclination and anteversion for left and right THAs of these three surgeons
Fig. 4
Fig. 4
a–d Spatial position of the surgeon during left and right THA. A and C are anteversion and inclination of left acetabular cup, B and D are anteversion and inclination of right acetabular cup, E and F are title angles of a surgeon body in left and right THA
See this image and copyright information in PMC

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