Effect of Pelvic Obliquity on the Orientation of the Acetabular Component in Total Hip Arthroplasty

In infrapelvic obliquity, coronal pelvic malrotation entails a change in the spatial location of the bony acetabulum. In the present study, 77 patients presented with infrapelvic obliquity with types 1 and 2 hip pathologies in which the pelvis is lower and higher, respectively, on the short-leg side. The 2 types were classified into 3 subtypes (A, B, and C) according to the severity of the pelvic obliquity (0°-3°, 3°-6°, and >6°). Angles of inclination of pelvic obliquity postoperatively, anteversions, and inclinations (abduction angle) for acetabular components were measured after total hip arthroplasty. Increased inclination (mean, 8.79°) was observed in type 1C, where the angle of inclination to pelvic obliquity postoperatively was minimally corrected. This increase may lead to cup instability. Rebalancing the pelvis in these cases with preoperative skeletal traction and/or sufficient release of hip contractures may be necessary. A correction of the mean inclination of the cup by 8.79° is required.