ArticleBMC musculoskeletal disorders2021
Effects of body mass index and range of motion on intraoperative change in pelvic tilt during total hip arthroplasty using the direct anterior approach.
Article in BMC musculoskeletal disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Three-Dimensional Pelvic Kinematics During Direct Anterior Approach Total Hip Arthroplasty on an Orthopaedic Table.Arthroplasty today · 2026Article
- Pelvic Position at Cup Placement Compared With Intraoperative Pelvic Motion in the Lateral Decubitus Position.Arthroplasty today · 2025Article
- A modified direct anterior approach for primary total hip arthroplasty: surgical technique.Journal of orthopaedic surgery and research · 2025Article
- Changes of spino-pelvic characteristics post-THA are independent of surgical approach: a prospective study.Archives of orthopaedic and trauma surgery · 2025Article
- Intraoperative Pelvic Tilt and Axial Rotation During Total Hip Arthroplasty Through the Direct Anterior Approach is Affected by the Acetabular Retractor and Cup Impactor.Arthroplasty today · 2023Article
- Accuracy of Acetabular Cup Placement During Total Hip Arthroplasty in Supine Position Using a Pelvic Rotation Correction Device.Arthroplasty today · 2022Article
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Authors and funding
5 authors.
Funding
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Abstract
backgroundIntraoperative pelvic tilt changes that occurs during total hip arthroplasty (THA) in the supine position affects cup placement and sometimes causes malalignment. The relationship between body mass index (BMI) and pelvic movement has been reported for some procedures, but not the direct anterior approach (DAA). The purpose of this study was to investigate intraoperative pelvic tilt changes that occurs during DAA.
methodsIn this single-center, retrospective study, we reviewed 200 hips that underwent primary THA via DAA in the supine position using an accelerometer-based navigation system. Intraoperative changes in pelvic tilt and axial rotation from the start of surgery to cup placement were assessed using the navigation system. Preoperative clinical factors that increased pelvic tilt and axial rotation toward the surgical side by > 10° were analyzed via univariate and multiple logistic regression analyses.
resultsThe mean pelvic tilt value increased by 7.6° ± 3.8° (95% confidence interval [CI], 7.1-8.2; range, - 5.0-19.0) intraoperatively, and the axial rotation increased by 3.2° ± 2.7° (95% CI, 2.7-3.7; range, - 13.0-12.0). Univariate analysis revealed that the group with increased pelvic tilt showed significantly greater range of abduction and internal rotation, and significantly lower BMI than the group with no increased tilt. Pre-incisional pelvic tilt was significantly greater in the group with increased axial rotation than in the group with no increased rotation. On logistic regression analysis, BMI (odds ratio [OR], 0.889; 95% CI, 0.809-0.977; p = 0.014) and the range of internal rotation (OR, 1.310; 95% CI, 1.002-1.061; p = 0.038) were predictors of large increases in pelvic tilt. No predictors of large increases in axial rotation were identified.
conclusionSignificant forward pelvic tilt was observed in patients with a low BMI values and high ranges of internal rotation via THA using the DAA. Findings indicated that surgeons should pay attention to intraoperative pelvic movements, which may help identify patients with significant pelvic tilt changes.
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