Transverse acetabular ligament as a marker for acetabular prosthesis anteversion in total hip arthroplasty

doi:10.12307/2021.190

Abstract

Abstract: BACKGROUND: There are a variety of reference standards for the placement of acetabular prosthesis in hip arthroplasty at present. Many surgeons only rely on visual measurement of standard anteversion abduction angle when fixing acetabular prosthesis. The transverse acetabular ligament was used as a reference point in this study.
OBJECTIVE: To study the value of transverse acetabular ligament as a marker of acetabular anteversion in total hip arthroplasty.
METHODS: The anatomic descriptive study of transverse acetabular ligament was carried out on fresh hip joint specimens to determine its course and position of starting and ending points, so as to provide the basis for the reconstruction of transverse acetabular ligament in three-dimensional reconstruction. Totally 192 adults (384 hips) with normal joints undergoing hip CT scan were selected, including 84 males and 108 females, at the age of > 18 years. A radiologist and an orthopedic surgeon diagnosed that bilateral acetabulum morphology was normal, without tumor, deformity, or severe osteophyte. Acetabular transverse ligament anteversion was measured in CT digital three-dimensional reconstruction. The results were compared with those of Lewinnek safe area and bony acetabulum.
RESULTS AND CONCLUSION: (1) Transverse acetabular ligament bridged the acetabular notch to form a complete circle. When the highest point of acetabulum was defined as 12 o'clock, transverse acetabular ligament was roughly located between 6 o'clock and 9 o'clock (taking the left side as an example). (2) The mean anteversion angle of transverse acetabular ligament was (12.9 ± 3.3)°, and the anteversion angle of three hips (6%) was beyond the safe area defined by Lewinnek (15±10)°. The average acetabular anteversion was (17.7±3.8)°, which was 4.7° larger than that of transverse acetabular ligament. (3) There was a significant correlation between transverse acetabular ligament anteversion and acetabular anteversion (r=0.759, P < 0.01). (4) It is concluded that in the hip joint with normal acetabular morphology, the alignment of transverse acetabular ligament anteversion and acetabular anteversion is not completely consistent, but there is an obvious correlation between them. Therefore, transverse acetabular ligament can be used as an anatomical marker for locating acetabular cup anteversion in total hip arthroplasty.

Key words: total hip arthroplasty, transverse acetabular ligament, anatomical anteversion, anatomy, location mark

CLC Number:

Li Long, Wang Hailong, Kang Peng, Chen Shengguo, Yilihamu•Tuoheti. Transverse acetabular ligament as a marker for acetabular prosthesis anteversion in total hip arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(27): 4322-4326.

Figures/Tables 3

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