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Optimal Anatomic Acetabular Component Positioning and Size for Total Hip Arthroplasty via the Direct Anterior Approach

March 01, 2019

Contributors: Evan J Hawkins, MD; Joseph D Lipman, MS; Luke Gregory Menken, DO; Nathaniel Mercer, BA, MS; Jonathan Robinson, MD; Jose A Rodriguez, MD; Jose A Rodriguez, MD

2019 AWARD WINNER A comprehensive strategy is important to ensure reproducible and safe acetabular component size and positioning for total hip arthroplasty via the direct anterior approach. This video presents our approach for achieving optimal anatomic acetabular component positioning for total hip arthroplasty via the direct anterior approach. This strategy has evolved alongside our understanding of acetabular cup size and positioning and their effects on instability and impingement. The goal is to optimize cup positioning and size to decrease the risk of iliopsoas impingement and instability during total hip arthroplasty via the direct anterior approach. Data collected by a single surgeon (J.A.R.) between 2009 and 2011 influenced our current paradigm for acetabular cup positioning and size. Socket positioning and size affects dislocation rates and groin pain. This video is an attempt to mitigate the prevalence of these complications. The video begins by introducing the common methodologies for positioning and sizing the acetabular component in patients undergoing total hip arthroplasty via the posterior approach. We then juxtapose these sizing and positioning parameters with those for the direct anterior approach and demonstrate how they markedly differ.

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