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Three-dimensional in vivo difference between native acetabular version and acetabular component version influences iliopsoas impingement after total hip arthroplasty

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Abstract

Purpose

The potential influence of acetabular component orientation on iliopsoas impingement in total hip arthroplasty (THA) has not been previously quantified. The aim of the present study was to utilize pre- and post-operative CT-based 3D models to quantify iliopsoas impingement on acetabular components, and to identify any potential factors associated with iliopsoas impingement.

Methods

Iliopsoas muscle was modelled from pre-operative CT scans and transferred to the post-operative 3D models in 19 THAs. The volume and the area of the overlap between iliopsoas muscle and acetabular cup (iliopsoas volume & area) was measured on axial and sagittal images. Most protruded lengths of cup uncovered by acetabular bone were measured on axial sagittal scan of CT scans. Version of acetabulum, acetabular cup, and the difference between the two (version difference) were also measured with cup inclination and size. Linear regression analysis was performed to identify any factor influencing iliopsoas impingement.

Results

Iliopsoas impingement volume and area were 100.6 ± 226.1 (range, 0.0–663.9) mm³ and 52.6 ± 102.0 (0.0–342.3) mm³, respectively. The protruded lengths on axial and sagittal view were 6.9 ± 5.3 (0.0–16.0) and 2.1 ± 2.7 (0.0–8.0). Linear regression model showed that version difference was significantly related to the iliopsoas impingement volume and area (beta = −0.709, p = 0.041 for volume, and beta = −0.684, p = 0.047 for area).

Conclusions

The results of this study demonstrate that iliopsoas impingement on acetabular components was influenced by the version difference between pre-operative acetabular bone and acetabular component rather than the magnitude of post-operative cup version alone.

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Acknowledgments

The authors would like to acknowledge the technical guidance of Dr. Guoan Li. There was a partial funding from Mako Surgical Inc.

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Authors and Affiliations

  1. Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Kwan Kyu Park, Tsung-Yuan Tsai, Dimitris Dimitriou & Young-Min Kwon

  2. Department of Orthopaedic Surgery, College of Medicine, Yonsei University, Seoul, Korea

    Kwan Kyu Park

  3. Department of Orthopaedic Surgery Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA

    Young-Min Kwon

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  1. Kwan Kyu Park
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  2. Tsung-Yuan Tsai
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  3. Dimitris Dimitriou
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  4. Young-Min Kwon
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Correspondence to Young-Min Kwon.

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Conflict of interest

The authors declare no competing interests.

Ethical review committee statement

This study was approved by the Institutional Review Board at the authors’ institute.

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Park, K.K., Tsai, TY., Dimitriou, D. et al. Three-dimensional in vivo difference between native acetabular version and acetabular component version influences iliopsoas impingement after total hip arthroplasty. International Orthopaedics (SICOT) 40, 1807–1812 (2016). https://doi.org/10.1007/s00264-015-3055-5

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  • DOI: https://doi.org/10.1007/s00264-015-3055-5

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