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Anatomic Navigation for Acetabular Component Positioning in Total Hip Arthroplasty via the Direct Anterior Approach

March 01, 2020

Contributors: Justin Paul Kuether, MD; Lee Eric Rubin, MD, FAAOS; David Ari Molho, MD

Keywords: Outcomes

2020 AWARD WINNER We propose that use of the transverse acetabular ligament during total hip arthroplasty via the direct anterior approach accurately guides abduction and anteversion positioning of the acetabular component. In our series of 31 primary total hip arthroplasty procedures performed by a single surgeon, we used PolyWare software to calculate abduction and anteversion of the acetabular component. The mean abduction angle was 48° (range, 38° to 62°; 90% in safe zone of 30° to 50°), and the mean anteversion angle was 13° (range, 6° to 22°; 100% in safe zone of 5° to 25°). We conclude that the concept of anatomic navigation is a reproducible and accurate method for acetabular component positioning in total hip arthroplasty via the direct anterior approach, requiring no additional technology, such as intraoperative fluoroscopy or computer navigation. This technique is easily reproducible and cost-effective and likely can be used to aid in cup positioning during total hip arthroplasty via any approach.

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