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Toward a Dynamic Approach of THA Planning Based on Ultrasound.

Abstract : The risk of dislocation after THA reportedly is minimized if the acetabular implant is oriented at 45 degrees inclination and 15 degrees anteversion with respect to the anterior pelvic plane. This reference plane now is used in computer-assisted protocols. However, this static approach may lead to postoperative instability because the dynamic variations of the pelvis influence effective cup orientation and are not taken into account in this approach. We propose an ultrasound tool to register the preoperative dynamics of the pelvis for THA planning during computer-assisted surgery. To assess this pelvic behavior and its consequences on implant orientation, we tested a new 2.5-dimensional ultrasound-based approach. The pelvic flexion was registered in sitting, standing, and supine positions in 20 subjects. The mean values were -25.2 degrees +/- 5.8 degrees (standard deviation), 2.4 degrees +/- 5.1 degrees , and 6.8 degrees +/- 3.5 degrees , respectively. The mean functional anteversion varied by 26 degrees and the mean functional inclination by 12 degrees depending on the pelvic flexion. We therefore recommend including dynamic pelvic behavior to minimize dislocation risk. The notion of a safe zone should be revisited and extended to include changes with activity.
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https://www.hal.inserm.fr/inserm-00311508
Contributor : Guillaume Dardenne <>
Submitted on : Monday, August 18, 2008 - 4:16:14 PM
Last modification on : Wednesday, June 24, 2020 - 4:18:44 PM
Long-term archiving on: : Saturday, November 26, 2016 - 12:39:18 AM

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Guillaume Dardenne, Stéphane Dusseau, Chafiaa Hamitouche-Djabou, Christian Lefèvre, Eric Stindel. Toward a Dynamic Approach of THA Planning Based on Ultrasound.. Clinical Orthopaedic and Related Research, 2008, epub ahead of print. ⟨10.1007/s11999-008-0408-z⟩. ⟨inserm-00311508⟩

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