Improving the Accuracy of Acetabular Component Orientation: Avoiding Malposition

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J Am Acad Orthop Surg, Vol 18, No 5 Joseph T. Moskal, MD and Susan G. Capps, PhD Improper acetabular component orientation negatively affects the outcome of total hip arthroplasty through increasing dislocation rates, component impingement, bearing surface wear, and the number of revision surgeries. Leg length, hip biomechanics, pelvic osteolysis, and acetabular component migration are also affected by malposition. With conventional techniques, numerous variables, such as patient size, deformity and/or position, and decreased visualization, contribute to inter- and intrasurgeon acetabular component variability during surgery regardless of surgeon experience and practice volume. New acetabular component implantation techniques, such as patient-specific morphology, that incorporate anatomic landmarks may provide more accurate and individualized target zones. These techniques, coupled with the use of quantitative technology such as computer-aided navigation, may improve the precision of acetabular component placement.