The use of the transverse acetabular ligament for determining the orientation of the components in total hip replacement: a randomised controlled trial
2014
The orientation of the acetabular component can
influence both the short- and long-term outcomes of total hip replacement
(THR). We performed a prospective, randomised, controlled trial
of two groups, comprising of 40 patients each, in order to compare
freehand introduction of the component with introduction using the transverse
acetabular ligament (TAL) as a reference for anteversion. Anteversion
and inclination were measured on pelvic radiographs. With respect to anteversion, in the freehand group 22.5% of the
components were outside the safe zone versus 0%
in the transverse acetabular ligament group (p = 0.002). The mean
angle of anteversion in the freehand group was 21° (2° to 35°) which
was significantly higher compared with 17° (2° to 25°) in the TAL
group (p = 0.004). There was a significant difference comparing
the variations of both groups (p = 0.008). With respect to inclination, in the freehand group 37.5% of the
components were outside the safe zone versus 20%
in the TAL group (p = 0.14). There was no significant difference
regarding the accuracy or variation of the angle of inclination
when comparing the two groups. The transverse acetabular ligament may be used to obtain the
appropriate anteversion when introducing the acetabular component
during THR, but not acetabular component inclination. Cite this article: Bone Joint J 2014;96-B:312–18.
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