Correction of pelvic adduction during total hip arthroplasty reduces variability in radiographic inclination: findings of a randomised controlled trial.

Introduction: The study aims were to identify the incidence of pelvic adduction during total hip arthroplasty (THA) in lateral decubitus and to determine, when aiming for 35° of apparent operative inclination (AOI), which of 3 operating table positions most accurately obtained a target radiographic inclination (RI) of 42°: (1) horizontal; (2) 7° head-down; (3) patient-specific position based on correction of pelvic adduction.

Methods: With patients seated on a levelled theatre table, a ruler incorporating a spirit level was used to draw transverse pelvic lines (TPLs) on the skin overlying the pelvis and sacrum. Subsequently, when positioned in lateral decubitus these lines provided a measure of pelvic adduction.

Reducing variability in apparent operative inclination during total hip arthroplasty: findings of a randomised controlled trial.

Aims: To determine which of 3 methods of cup insertion most accurately achieved a target apparent operative inclination (AOI) of 35° ± 2.5°: (1) Freehand; (2) Modified Mechanical Alignment Guide (MAG); or (3) Digital Inclinometer assisted.

Methods: Using a cementless cup via a posterior approach in lateral decubitus 270 participants were recruited, with 90 randomised to each method.

Acetabular Liner Dissociation following Total Hip Arthroplasty: A Rare but Serious Complication That May Be Easily Misinterpreted in the Emergency Department.

Acetabular liner dissociation is a rare complication of Total Hip Arthroplasty (THA) which requires urgent revision surgery. A case is presented in which the correct diagnosis was not appreciated on two separate Emergency Department attendances. The typical symptoms, signs, and radiological features are outlined and the importance of considering a rare complication following a commonly performed procedure is highlighted.