Does Technology Contribute to Accurate Cup Placement in THA?

    How to achieve accurate acetabular component placement remains one of the most-debated issues in total hip arthroplasty.

    At the Pan Pacific Orthopaedic Congress, Jennifer J. Christopher, BS, from Stryker reviewed a study involving nearly 2,000 THA patients from 6 surgeons that evaluated and compared component placement for the following:

    • Conventional posterior THA
    • Intraoperative x-ray-guided posterior THA
    • Fluoroscopic-guided anterior THA
    • Navigation-guided anterior THA
    • Robotic-guided posterior THA
    • Robotic-guided anterior THA

    They assessed the accuracy of acetabular cup placement according to the safe zones described by Lewinnek et al and Callanan et al. They calculated inclination, version, leg length discrepancy, and glopbal offset difference from retrospectively collected radiographic measurements.

    For the Lewinnek safe zone, acetabular cup placement was found to be more consistent with the robotic-guided and navigation-guided techniques than with the other techniques. For the Callanan safe zone, robotic-guided surgery provided more consistent cup placement.

    What this means for cup placement is unclear. The authors suggest that more investigation is needed to determine long-term clinical outcomes, complications, and cost-effectiveness of various techniques and modes of guidance in THA.

    Click the image above to hear Ms. Christopher discuss the study findings. As she notes, the study shows that advanced technologies can improve cup placement, but the optimum position is yet to be determined.

    Producer: Michael Szuch; Director: Michael Bugera; Post Production: Charles J. Maynard


    Domb B, Redmond J, Petrakos A, Gui C, Chandrasekaran S, Conditt M, Suarez-Ahedo C. Accuracy of component positioning in 2330 total hip arthroplasties: a comparative analysis by technique and guidance. Presented at the 2nd Annual Pan Pacific Orthopaedic Congress, July 22-25, 2015, Kona, Hawaii.