{
    "abstract": "Incorrect acetabular component positioning during total hip arthroplasty (THA) may lead to dislocation, impingement, wear and revision. Surgeons commonly use the transverse acetabular ligament (TAL) as a landmark for acetabular component orientation. The posterior acetabular wall (PAW) is a structure easily viewed on plain radiography and its position can help guide acetabular component position. In this study, we examine the efficacy of preoperative radiographs in predicting cup position relative to the PAW.\nProspective data was recorded on radiographic findings of the posterior wall (prominent, normal, deficient) on a consecutive series of 200 primary THAs utilising a standardised posterior approach. The final cup position relative to the wall was recorded (prominent, flush, deep). Cup inclination and version were then assessed by postoperative radiography and any instances of dislocation recorded.\nThere were 117 females and 83 males with a mean age of 66.5 years. 154 were recorded as having a normal PAW on radiographs, 152 had the cup positioned in line with the TAL and flush to the PAW. 29 had a deficient PAW and 27 of these had a cup positioned prominently with 17 having a prominent PAW and of these 16 a deep cup position. Postoperative radiographs showed a mean cup version of 20.8\u00b0 and inclination of 44.7\u00b0 using this method. There were 21 outliers (10.5%) with no dislocations at a minimum 12-month follow-up.\nThe TAL is a continuation of the posterior labrum. As such, the posterior wall is a useful adjunct to and surrogate landmark for the TAL. It has the added advantage that it is visible on radiographs and so aids surgical planning with respect to cup positioning.",
    "authors": [
        {
            "affiliation": "Orthopaedic Department, Royal Cornwall Hospital, Truro - UK.",
            "firstname": "Huw L M",
            "initials": "HLM",
            "lastname": "Williams"
        },
        {
            "affiliation": "Orthopaedic Department, Royal Cornwall Hospital, Truro - UK.",
            "firstname": "Gavin E",
            "initials": "GE",
            "lastname": "Bartlett"
        },
        {
            "affiliation": "Orthopaedic Department, Royal Cornwall Hospital, Truro - UK.",
            "firstname": "Mark R",
            "initials": "MR",
            "lastname": "Norton"
        },
        {
            "affiliation": "Orthopaedic Department, Royal Cornwall Hospital, Truro - UK.",
            "firstname": "Rory G",
            "initials": "RG",
            "lastname": "Middleton"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.5301/hipint.5000531",
    "journal": "Hip international : the journal of clinical and experimental research on hip pathology and therapy",
    "keywords": [
        "Dislocation",
        "Total hip arthroplasty",
        "Transverse acetabular ligament"
    ],
    "methods": null,
    "publication_date": "2017-09-09",
    "pubmed_id": "28885650",
    "results": "There were 117 females and 83 males with a mean age of 66.5 years. 154 were recorded as having a normal PAW on radiographs, 152 had the cup positioned in line with the TAL and flush to the PAW. 29 had a deficient PAW and 27 of these had a cup positioned prominently with 17 having a prominent PAW and of these 16 a deep cup position. Postoperative radiographs showed a mean cup version of 20.8\u00b0 and inclination of 44.7\u00b0 using this method. There were 21 outliers (10.5%) with no dislocations at a minimum 12-month follow-up.",
    "title": "The posterior acetabular wall (PAW): an aid to acetabular orientation at primary THA.",
    "xml": "<Element 'PubmedArticle' at 0x788503a54540>"
}