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provides an overview of the hip–spine relationship and its implications for patients undergoing total hip arthroplasty (THA). A crucial step in THA is to position the cup in such a way to obtain a stable joint without neck-cup impingement or edge loading
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-determined ‘safe zone’. The most common type of navigation utilises a simple mechanical alignment rod. The surgeon uses experience to judge the position of cup anteversion compared with the patient’s superior shoulder, and the position of inclination when compared
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to inter-patient variations in anatomical landmarks for referencing, subjective assessments of optimal jig positioning, and lack of objective intraoperative data on limb alignment. 15 , 18 , 19 Suboptimal pin placement into the tibial cortex, re
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at the time of impaction ( 20 ). The optimal position of the centre of rotation (COR) of the cup depends on the anatomy of the patient, more specifically acetabular floor depth, and the reaming technique ( 21 ). Table 1 Results of freehand cup
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service life and, not least, dissatisfied patients. 2 - 4 For the use of the conventional freehand technique, both precise pre-operative planning and intra-operative re-evaluation are essential for correct implant positioning and optimal function
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polyethylene wear, it was initially recommended that implants were positioned in a ‘biomechanically friendly’ way, which disregarded most of the individual patient anatomy. 1 - 5 Therefore, knee implants were aligned perpendicular to the femoral and tibial
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alignment techniques) for knee implant positioning ( Fig. 1 ) and to summarize the evidence behind each one. Fig. 1 Different techniques for aligning total knee arthroplasty implants on a patient with 6° constitutional varus limb alignment. From left
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. Clear advantages in total knee arthroplasty are the fact that it is very intuitive and effective in placing the components in the desired position, it is attractive to patients because they like a personalised patient-care approach and it increases
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important for acetabular component anteversion. Existing lumbar deformities are structural and they rarely respond to the reconstruction of hip joint position. Patients presenting with previously-operated hips might have more severe femoral site deformities
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serious problem for young patients, for whom an early revision is not only a major setback in the short term, but a serious threat to the long-term function of the limb. 2 Instability and stiffness are directly related to the position, size and
