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Screw-hole clusters in acetabular cups: a morphological study of optimal positioning of screw-holes

Screw-hole clusters in acetabular cups: a morphological study of optimal positioning of screw-holes

Post author correction

Article Type: ORIGINAL RESEARCH ARTICLE

Article Subject: Hip replacement

DOI:10.5301/hipint.5000471

Authors

Xinghua Yin, Yixin Zhou, Qiheng Tang, Dejin Yang, Hao Tang, Xingjian Huang

Abstract

Background

Rigid and safe transacetabular screw fixation in total hip arthroplasty (THA) is achieved by pursuing deeper bone stock and avoiding injuries to the neurovascular structures, but these efforts can be restricted by the distribution of screw-holes on cups by the manufacturer. We therefore tried to determine: (i) optimal screw-hole positions on cups to allow anatomical placement of screws; (ii) rationality of the basic 3-screw-hole cluster on commercial cups; and (iii) the optimum method for placing commercial cups in accordance with acetabular anatomy.

Methods

Periacetabular osseous structure of 64 hips and arterial structures of 50 hips were three-dimensionally reconstructed. Simulated transacetabular screw fixation during THA was performed in these hips with 3 different screw lengths (15, 25, and 35 mm) to define deeper and safer screw trajectories. Screw-hole locations of 7 commercially available cups were measured and matched with the periacetabular anatomy.

Results

When the cup was placed into the acetabulum at 45° of abduction and 20° of anteversion, the optimal locations of 2 screw-holes on the cups were at 30° and 64° of latitude, with a 35° separation angle. The inversetriangle distribution pattern was safer than the triangle pattern in basic 3-screw-hole-cluster cups. When placing the commercial cups, 5°-10° of anterior rotation can be added to allow better screw trajectories.

Conclusions

Our study determined optimal screw-hole positions and their distribution pattern on cups. We describe methods to place the commercial cups that are not designed according to acetabular anatomy.

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

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Authors

Affiliations

  • Department of Orthopaedics, Beijing Jishuitan Hospital, Beijing - China

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