Evidence map›Paper›PMID 40560254›Full record

ReviewArchives of orthopaedic and trauma surgery2025

Acetabular screws placement in primary and revision total hip arthroplasty: a narrative review.

Niccolò Stefanini, Davide Pederiva, Matteo Brunello, Giuseppe Geraci, Federico Pilla, Enrico Capozzi, Alberto Di Martino, Cesare Faldini

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In one paragraph

Review in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Niccolò StefaniniIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Davide PederivaIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Matteo BrunelloIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Giuseppe GeraciIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Federico PillaIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Enrico CapozziIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Alberto Di MartinoIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. albertocorrado.dimartino@ior.it.
Cesare FaldiniIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTotal Hip Arthroplasty (THA) is one of the most successful procedures in orthopedic surgery. Today, arthroplasties are performed using minimally invasive techniques, with excellent long-term outcomes. However, complex cases, such as dysplastic hips, acetabular fractures, or revision surgeries involving bone loss, continue to represent significant challenges for surgeons in achieving primary stability. In such situations, acetabular screws can be used to improve stability, although this increases technical difficulties and the risk of neurovascular complications. This review aims to describe the optimal techniques for acetabular screw placement in THA, focusing on ensuring primary stability while minimizing risks. It also discusses the safe zones for screw placement based on acetabular anatomy and evaluates different acetabular component designs. A narrative review of the literature was conducted, addressing acetabular screw placement in the ilium, ischium, and pubic bone. A clock-face method and graphics are used to illustrate the optimal entry points for screws. The risk associated with various zones (e.g., the "death zone" and "caution zone") is highlighted. The iliac bone offers the best tolerance for screw placement, with a wide range of safe angles, whereas the ischium and pubis present narrower safety angles due to proximity to vital structures. Progressively more invasive types of prostheses are also discussed for severe cases of bone loss and reduced stability. The review emphasizes the importance of surgeon expertise and anatomical knowledge, particularly in high-complexity cases where bone stock is severely compromised.

conclusionsProper acetabular component selection and placement and screw fixation techniques are crucial for the success of both difficult primary and revision THA. Surgeons must be aware of the technical difficulties and the anatomical variations that can occur in difficult cases, to avoid complications, namely neurovascular injuries.

Indexed as

AcetabulumArthroplasty, Replacement, HipBone ScrewsHumansReoperationAcetabular screwsComplicationsRevision surgeryScrew placement zonesTotal hip arthroplasty

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.