Validation of a preoperative formula to estimate postoperative pelvic sagittal alignment and mobility before performing total hip arthroplasty for patients with hip osteoarthritis

doi:10.1186/s42836-023-00171-w

. 2023 Apr 5;5(1):13.

doi: 10.1186/s42836-023-00171-w.

Validation of a preoperative formula to estimate postoperative pelvic sagittal alignment and mobility before performing total hip arthroplasty for patients with hip osteoarthritis

Hiroki Tanabe^{1

2}, Yasuhiro Homma^{3

4}, Naotake Yanagisawa⁵, Taiji Watari², Seiya Ishii², Yuichi Shirogane^{1

2}, Tomonori Baba^{1

2}, Kazuo Kaneko^{1

2}, Muneaki Ishijima^{1

2}

Affiliations

¹ Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
² Department of Orthopaedic, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
³ Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. yhomma@juntendo.ac.jp.
⁴ Department of Orthopaedic, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. yhomma@juntendo.ac.jp.
⁵ Medical Technology Innovation Center, Juntendo University, Tokyo, 113-0033, Japan.

PMID: 37020254
PMCID: PMC10077599
DOI: 10.1186/s42836-023-00171-w

Validation of a preoperative formula to estimate postoperative pelvic sagittal alignment and mobility before performing total hip arthroplasty for patients with hip osteoarthritis

Hiroki Tanabe et al. Arthroplasty. 2023.

. 2023 Apr 5;5(1):13.

doi: 10.1186/s42836-023-00171-w.

Authors

Hiroki Tanabe^{1

2}, Yasuhiro Homma^{3

4}, Naotake Yanagisawa⁵, Taiji Watari², Seiya Ishii², Yuichi Shirogane^{1

2}, Tomonori Baba^{1

2}, Kazuo Kaneko^{1

2}, Muneaki Ishijima^{1

2}

Affiliations

¹ Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
² Department of Orthopaedic, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
³ Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. yhomma@juntendo.ac.jp.
⁴ Department of Orthopaedic, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. yhomma@juntendo.ac.jp.
⁵ Medical Technology Innovation Center, Juntendo University, Tokyo, 113-0033, Japan.

PMID: 37020254
PMCID: PMC10077599
DOI: 10.1186/s42836-023-00171-w

Abstract

Background: Although it is important to consider pelvic alignment and mobility in the standing and sitting positions before THA, it is not known how to preoperatively predict individual postoperative pelvic alignment and mobility. The purpose of this study was to investigate the pelvic alignment and mobility before and after THA, and to develop a predictive formula using preoperative factors to calculate postoperative sagittal alignment and mobility.

Methods: One hundred seventy patients were assessed. The 170 patients were randomly divided into a prediction model analysis group (n = 85) and an external validation group (n = 85). In the prediction model analysis group, preoperative spinopelvic parameters were used to develop the predictive formulas to predict the postoperative sacral slope (SS) in standing and sitting positions and ΔSS. These were applied to the external validation group and assessed.

Results: R² in multiple linear regression models for postoperative SS in standing, SS in sitting and ΔSS were 0.810, 0.672, and 0.423, respectively. The values of predicted and postoperative parameters were very close with no significant difference: SS in standing (33.87 vs. 34.23, P = 0.834), SS in sitting (18.86 vs. 19.51, P = 0.228), and ΔSS (15.38 vs. 14.72, P = 0.619).

Conclusion: The present study showed that the pelvic alignment and mobility after THA can be predicted using preoperative factors. Although a model with higher accuracy is needed, it is important to use a predictive formula to estimate the postoperative condition before performing THA.

Keywords: Pelvic alignment; Pelvic mobility; Predictive formulas; Sagittal balance; Total hip arthroplasty; Validation.

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Conflict of interest statement

We declare the authors have no conflict of interests.

Figures

**Fig. 2**
Lateral radiographs of a patient in the standing (left) and sitting (right) positions. Illustration of the spinopelvic parameters. TK, thoracic kyphosis angle; LL, lumbar lordosis angle; SS, sacral slope; PI, pelvic incidence

See this image and copyright information in PMC

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References

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1. Danoff JR, Bobman JT, Cunn G, Murtaugh T, Gorroochurn P, Geller JA, et al. Redefining the acetabular component safe zone for posterior approach total hip arthroplasty. J Arthroplasty. 2016;31(2):506–511. doi: 10.1016/j.arth.2015.09.010. - DOI - PubMed
1. Reina N, Putman S, Desmarchelier R, Sari Ali E, Chiron P, Ollivier M, et al. Can a target zone safer than Lewinnek’s safe zone be defined to prevent instability of total hip arthroplasties? Case-control study of 56 dislocated THA and 93 matched controls. Orthop Traumatol Surg Res. 2017;103(5):657–661. doi: 10.1016/j.otsr.2017.05.015. - DOI - PubMed
1. Seagrave KG, Troelsen A, Malchau H, Husted H, Gromov K. Acetabular cup position and risk of dislocation in primary total hip arthroplasty. Acta Orthop. 2017;88(1):10–17. doi: 10.1080/17453674.2016.1251255. - DOI - PMC - PubMed
1. Abdel MP, von Roth P, Jennings MT, Hanssen AD, Pagnano MW. What safe zone? The vast majority of dislocated THAs are within the lewinnek safe zone for acetabular component position. Clin Orthop Relat Res. 2016;474(2):386–391. doi: 10.1007/s11999-015-4432-5. - DOI - PMC - PubMed

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[1] Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978;60(2):217–220. doi: 10.2106/00004623-197860020-00014. - DOI - PubMed

[2] Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978;60(2):217–220. doi: 10.2106/00004623-197860020-00014. - DOI - PubMed

[3] Danoff JR, Bobman JT, Cunn G, Murtaugh T, Gorroochurn P, Geller JA, et al. Redefining the acetabular component safe zone for posterior approach total hip arthroplasty. J Arthroplasty. 2016;31(2):506–511. doi: 10.1016/j.arth.2015.09.010. - DOI - PubMed

[4] Danoff JR, Bobman JT, Cunn G, Murtaugh T, Gorroochurn P, Geller JA, et al. Redefining the acetabular component safe zone for posterior approach total hip arthroplasty. J Arthroplasty. 2016;31(2):506–511. doi: 10.1016/j.arth.2015.09.010. - DOI - PubMed

[5] Reina N, Putman S, Desmarchelier R, Sari Ali E, Chiron P, Ollivier M, et al. Can a target zone safer than Lewinnek’s safe zone be defined to prevent instability of total hip arthroplasties? Case-control study of 56 dislocated THA and 93 matched controls. Orthop Traumatol Surg Res. 2017;103(5):657–661. doi: 10.1016/j.otsr.2017.05.015. - DOI - PubMed

[6] Reina N, Putman S, Desmarchelier R, Sari Ali E, Chiron P, Ollivier M, et al. Can a target zone safer than Lewinnek’s safe zone be defined to prevent instability of total hip arthroplasties? Case-control study of 56 dislocated THA and 93 matched controls. Orthop Traumatol Surg Res. 2017;103(5):657–661. doi: 10.1016/j.otsr.2017.05.015. - DOI - PubMed

[7] Seagrave KG, Troelsen A, Malchau H, Husted H, Gromov K. Acetabular cup position and risk of dislocation in primary total hip arthroplasty. Acta Orthop. 2017;88(1):10–17. doi: 10.1080/17453674.2016.1251255. - DOI - PMC - PubMed

[8] Seagrave KG, Troelsen A, Malchau H, Husted H, Gromov K. Acetabular cup position and risk of dislocation in primary total hip arthroplasty. Acta Orthop. 2017;88(1):10–17. doi: 10.1080/17453674.2016.1251255. - DOI - PMC - PubMed

[9] Abdel MP, von Roth P, Jennings MT, Hanssen AD, Pagnano MW. What safe zone? The vast majority of dislocated THAs are within the lewinnek safe zone for acetabular component position. Clin Orthop Relat Res. 2016;474(2):386–391. doi: 10.1007/s11999-015-4432-5. - DOI - PMC - PubMed

[10] Abdel MP, von Roth P, Jennings MT, Hanssen AD, Pagnano MW. What safe zone? The vast majority of dislocated THAs are within the lewinnek safe zone for acetabular component position. Clin Orthop Relat Res. 2016;474(2):386–391. doi: 10.1007/s11999-015-4432-5. - DOI - PMC - PubMed

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Validation of a preoperative formula to estimate postoperative pelvic sagittal alignment and mobility before performing total hip arthroplasty for patients with hip osteoarthritis

Affiliations

Validation of a preoperative formula to estimate postoperative pelvic sagittal alignment and mobility before performing total hip arthroplasty for patients with hip osteoarthritis

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