Research progress in safe zone of prosthesis position of total hip arthroplasty

doi:10.3877/cma.j.issn.1674-134X.2023.02.016

Abstract

Abstract:

Dislocation is one of the most common complications of total hip arthroplasty. An appropriate positioning of acetabular and femoral prosthesis is paramount to reduce the risk of dislocation. Lewinnek safe zone, which has been regarded as the standard of prosthesis positioning over the last 40 years, has been challenged recently because it merely emphasises the static acetabular position and ignores the effect of femoral and pelvic motion on hip stability. As the understanding of the essential of femoral anteversion deepens, the concept of combined anteversion has begun to prevail. Increasing researches are focusing on the kinematics and interrelationship of spine-pelvis-hip conceptualised the functional safe zone. Safe zones described above fail to take into account the differences in morphology and kinematics of individual patients, therefore, the patient-specific safe zone based on anatomy of individual patient and kinematics of spine-pelvic complex is much anticipated. In this review, the history and progress of various safe zones of total hip arthroplasty were summarised.

Key words: Arthroplasty, replacement, hip, Hip dislocation

Qizhong Wang, Hui Li. Research progress in safe zone of prosthesis position of total hip arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(02): 261-266.

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References 50

[1]	Gwam CU, Mistry JB, Mohamed NS, et al. Current epidemiology of revision total hip arthroplasty in the United States: national inpatient sample 2009 to 2013[J]. J Arthroplasty, 2017, 32(7): 2088-2092.
[2]	Bozic KJ, Kurtz SM, Lau E, et al. The epidemiology of revision total knee arthroplasty in the United States[J]. Clin Orthop Relat Res, 2010, 468(1): 45-51.
[3]	Khatod M, Barber T, Paxton E, et al. An analysis of the risk of hip dislocation with a contemporary total joint registry[J]. Clin Orthop Relat Res, 2006, 447: 19-23.
[4]	Berry DJ, von Knoch M, Schleck CD, et al. The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty[J]. J Bone Joint Surg Am, 2004, 86(1): 9-14.
[5]	Morrey BF. Difficult complications after hip joint replacement. Dislocation[J]. Clin Orthop Relat Res, 1997(344): 179-187.
[6]	唐锡国，杨武，唐锡辉，等. 前侧及后外侧入路髋臼假体安放位置的比较[J/CD]. 中华关节外科杂志(电子版), 2019, 13(6): 755-759.
[7]	Kostensalo I, Junnila M, Virolainen P, et al. Effect of femoral head size on risk of revision for dislocation after total hip arthroplasty: a population-based analysis of 42, 379 primary procedures from the finnish arthroplasty register[J]. Acta Orthop, 2013, 84(4): 342-347.
[8]	Hailer NP, Weiss RJ, Stark A, et al. The risk of revision due to dislocation after total hip arthroplasty depends on surgical approach, femoral head size, sex, and primary diagnosis. An analysis of 78, 098 operations in the Swedish Hip Arthroplasty Register[J]. Acta Orthop, 2012, 83(5): 442-448.
[9]	Malik A, Maheshwari A, Dorr LD. Impingement with total hip replacement[J]. J Bone Joint Surg Am, 2007, 89(8): 1832-1842.
[10]	马卫华，吴富源，曲广运，等. 不同髋臼杯前倾位置和球头假体大小对全髋关节置换术后后方稳定性的影响[J/CD]. 中华关节外科杂志(电子版), 2009, 3(5): 624-629.
[11]	Lewinnek GE, Lewis JL, Tarr R, et al. Dislocations after total hip-replacement arthroplasties[J]. J Bone Joint Surg Am, 1978, 60(2): 217-220.
[12]	Reina N, Putman S, Desmarchelier R, et al. Can a target zone safer than Lewinnek’s safe zone be defined to prevent instability of total hip arthroplasties? Case-control study of 56 dislocated THA and 93 matched controls[J]. Orthop Traumatol Surg Res, 2017, 103(5): 657-661.
[13]	Callanan MC, Jarrett B, Bragdon CR, et al. The john charnley award: risk factors for cup malpositioning: quality improvement through a joint registry at a tertiary hospital[J]. Clin Orthop Relat Res, 2011, 469(2): 319-329.
[14]	Murphy WS, Yun HH, Hayden B, et al. The safe zone range for cup anteversion is narrower than for inclination in THA[J]. Clin Orthop Relat Res, 2018, 476(2): 325-335.
[15]	Abdel MP, von Roth P, Jennings MT, et al. What safe zone? the vast majority of dislocated THAs are within the lewinnek safe zone for acetabular component position[J]. Clin Orthop Relat Res, 2016, 474(2): 386-391.
[16]	Timperley AJ, Biau D, Chew D, et al. Dislocation after total hip replacement - there is no such thing as a safe zone for socket placement with the posterior approach[J]. Hip Int, 2016, 26(2): 121-127.
[17]	Lazennec JY, Thauront F, Robbins CB, et al. Acetabular and femoral anteversions in standing position are outside the proposed safe zone after total hip arthroplasty[J]. J Arthroplasty, 2017, 32(11): 3550-3556.
[18]	Heckmann N, Tezuka T, Bodner RJ, et al. Functional anatomy of the hip joint[J]. J Arthroplasty, 2021, 36(1): 374-378.
[19]	Kanawade V, Dorr LD, Wan Z. Predictability of acetabular component angular change with postural shift from standing to sitting position[J]. J Bone Joint Surg Am, 2014, 96(12): 978-986.
[20]	Pour AE, Schwarzkopf R, Patel KP, et al. Is combined anteversion equally affected by acetabular cup and femoral stem anteversion？[J]. J Arthroplasty, 2021, 36(7): 2393-2401.
[21]	Elkins JM, Callaghan JJ, Brown TD. The 2014 Frank Stinchfield Award: the 'landing zone’ for wear and stability in total hip arthroplasty is smaller than we thought: a computational analysis[J]. Clin Orthop Relat Res, 2015, 473(2): 441-452.
[22]	Widmer KH, Zurfluh B. Compliant positioning of total hip components for optimal range of motion[J]. J Orthop Res, 2004, 22(4): 815-821.
[23]	Dorr LD, Malik A, Dastane M, et al. Combined anteversion technique for total hip arthroplasty[J]. Clin Orthop Relat Res, 2009, 467(1): 119-127.
[24]	McKibbin B. Anatomical factors in the stability of the hip joint in the newborn[J]. J Bone Joint Surg Br, 1970, 52(1): 148-159.
[25]	Maruyama M, Feinberg JR, Capello WN, et al. The Frank Stinchfield Award: Morphologic features of the acetabulum and femur: anteversion angle and implant positioning[J]. Clin Orthop Relat Res, 2001(393): 52-65.
[26]	Nakashima Y, Hirata M, Akiyama M, et al. Combined anteversion technique reduced the dislocation in cementless total hip arthroplasty[J]. Int Orthop, 2014, 38(1): 27-32.
[27]	Yoshimine F． The safe-zones for combined cup and neck anteversions that fulfill the essential range of motion and their optimum combination in total hip replacements[J]. J Biomech, 2006, 39(7): 1315-1323.
[28]	Ranawac CS, Maynard MJ. Modern technique of cemented total hip arthroplasty[J]. Tech Orthop, 1991, 6(3): 17-25.
[29]	Hernández A, Lakhani K, NúñezJH, et al. Can we trust combined anteversion and Lewinnek safe zone to avoid hip prosthesis dislocation？[J/OL]. J Clin Orthop Trauma, 2021, 21: 101562. DOI: 10.1016/j.jcot.2021.101562.
[30]	Tezuka T, Heckmann ND, Bodner RJ, et al. Functional safe zone is superior to the lewinnek safe zone for total hip arthroplasty: why the lewinnek safe zone is not always predictive of stability[J]. J Arthroplasty, 2019, 34(1): 3-8.
[31]	Esposito CI, Gladnick BP, Lee YY, et al. Cup position alone does not predict risk of dislocation after hip arthroplasty[J]. J Arthroplasty, 2015, 30(1): 109-113.
[32]	Lazennec JY, Riwan A, Gravez F, et al. Hip spine relationships: application to total hip arthroplasty[J]. Hip Int, 2007, 17(Suppl 5): S91-S104.
[33]	Heckmann N, McKnight B, Stefl M, et al. Late dislocation following total hip arthroplasty: spinopelvic imbalance as a causative factor[J]. J Bone Joint Surg Am, 2018, 100(21): 1845-1853.
[34]	Luthringer TA, Vigdorchik JM. A preoperative workup of a "hip-spine" total hip arthroplasty patient: asimplified approach to a complex problem[J]. J Arthroplasty, 2019, 34(7): S57-S70.
[35]	Windsor EN, Sharma AK, Premkumar A, et al. The use of technology to achieve the functional acetabular safe zone in total hip arthroplasty[J/OL]. JBJS Rev, 2022, 10(2). DOI: 10.2106/JBJS.RVW.21.00070.
[36]	Lum ZC, Coury JG, Cohen JL, et al. The Current knowledge on spinopelvic mobility[J]. J Arthroplasty, 2018, 33(1): 291-296.
[37]	Stefl M, Lundergan W, Heckmann N, et al. Spinopelvic mobility and acetabular component position for total hip arthroplasty[J]. Bone Joint J, 2017, 99-B(1 Supple A): 37-45.
[38]	Lazennec JY, Brusson A, Rousseau MA. Lumbar-pelvic-femoral balance on sitting and standing lateral radiographs[J]. Orthop Traumatol Surg Res, 2013, 99(1): S87-S103.
[39]	Maratt JD, Esposito CI, McLawhorn AS, et al. Pelvic tilt in patients undergoing total hip arthroplasty: when does it matter？[J]. J Arthroplasty, 2015, 30(3): 387-391.
[40]	Kim Y, Vergari C, Girinon F, et al. Stand-to-sit kinematics of the pelvis is not always as expected: hip and spine pathologies can have an impact[J]. J Arthroplasty, 2019, 34(9): 2118-2123.
[41]	Gausden EB, Parhar HS, Popper JE, et al. Risk factors for early dislocation following primary elective total hip arthroplasty[J]. J Arthroplasty, 2018, 33(5): 1567-1571.e2.
[42]	Phan D, Bederman SS, Schwarzkopf R. The influence of sagittal spinal deformity on anteversion of the acetabular component in total hip arthroplasty[J]. Bone Joint J, 2015, 97-B(8): 1017-1023.
[43]	Sharma AK, Vigdorchik JM. The hip-spine relationship in total hip arthroplasty: how to execute the plan[J]. J Arthroplasty, 2021, 36(7): S111-S120.
[44]	Rivière C, Harman C, Parsons T, et al. Kinematic alignment versus conventional techniques for total hip arthroplasty: a retrospective case control study[J]. Orthop Traumatol Surg Res, 2019, 105(5): 895-905.
[45]	Pierrepont J, Hawdon G, Miles BP, et al. Variation in functional pelvic tilt in patients undergoing total hip arthroplasty[J]. Bone Joint J, 2017, 99-B(2): 184-191.
[46]	Snijders TE, Schlösser TPC, van Straalen M, et al. Erratum to: the effect of postural pelvic dynamics on the three-dimensional orientation of the acetabular cup in THA is patient specific[J]. Clin Orthop Relat Res, 2021, 479(8): 1878-1879.
[47]	Habor J, Fischer MCM, Tokunaga K, et al. The patient-specific combined target zone for Morpho-functional planning of total hip arthroplasty[J/OL]. J Pers Med, 2021, 11(8): 817. DOI: 10.3390/jpm11080817.
[48]	Widmer KH. The impingement-free, prosthesis-specific, and anatomy-adjusted combined target zone for component positioning in THA depends on design and implantation parameters of both components[J]. Clin Orthop Relat Res, 2020, 478(8): 1904-1918.
[49]	Tang H, Li Y, Zhou Y, et al. A modeling study of a patient-specific safe zone for THA: calculation, validation, and key factors based on standing and sitting sagittal pelvic tilt[J]. Clin Orthop Relat Res, 2022, 480(1): 191-205.
[50]	Hsu J, de la Fuente M, Radermacher K. Calculation of impingement-free combined cup and stem alignments based on the patient-specific pelvic tilt[J]. J Biomech, 2019, 82: 193-203.

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