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physiological sagittal profile and muscle balance, and improve the patient’s quality of life. 5 , 6 Alignment is a static concept that refers to the positioning of the skeleton and the different skeletal elements when measured in a fixed image, e.g. as in
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described in another study by Shah et al. to minimize blood loss included tranexamic acid, permissive hypotension, central neuraxial anesthesia, correct patient positioning, and avoidance of hypothermia ( 60 ). The authors also reported promising
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X-ray image due to pelvic tilt following a lumbar arthrodesis. Fig. 3 Same implant and patient, different X-ray angle leading to different evaluation of cup orientation. (a) incorrect beam angle: cup too vertical and anteverted position
Service de Chirurgie Orthopédique, Clinique Maussins-Nollet, Paris, France
Clinique Nollet, Paris, France
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versatility, as most designs are available in a range of sizes, neck lengths and offsets. Custom femoral stems were introduced for selected THA patients, notably those with major anatomical deformities, 2 , 3 for which off-the-shelf implants would not be
Service de Chirurgie Orthopédique, Traumatologie et Chirurgie Réparatrice des Membres, Hôpital d’Instruction des Armées Percy, France
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Introduction Neurogenic heterotopic ossification (NHO) is a spontaneous differentiation of muscle tissues to endochondral bone in an unregulated fashion. This bone development occurs in patients who have sustained a traumatic neurological
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–47% of acetabular components are within the desired safe ranges of anteversion and inclination using these manual handheld techniques, and low surgeon volume has been identified as a risk factor for errors in implant positioning. 23 – 26 Patients
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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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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
