Pelvic tilt and movement during total hip arthroplasty in the lateral decubitus position

Masayuki Kanazawa, Yasuharu Nakashima, Masanobu Ohishi, Satoshi Hamai, Goro Motomura, Takuaki Yamamoto, Jun Ichi Fukushi, Takahiro Ushijima, Daisuke Hara, Yukihide Iwamoto

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


Objectives: Total hip arthroplasty (THA) is often performed in the lateral decubitus (lateral) position. In this position, the pelvis may have various degrees of tilt leading to implant malposition. We sought to quantify the pelvic tilt in lateral position and further pelvic movement during surgery.Methods: In 95 cases with primary THA, three-dimensional pelvic tilts were quantified by superimposing images reconstructed from CT data onto antero-posterior radiographs taken in lateral position at set-up and after cup placement. Pelvises were fixed with a device compressing anterior superior iliac spines and sacrum.Results: Various degrees of pelvic tilt occurred compared to the supine position; sagittal: -3.1° (-25.5° to 10.2°), axial: 3.9° (-8.4° to 17°), coronal: 0.9° (-11.9° to 13.2°). Absolute changes more than 5° were observed 43%, 47%, and 12% in the sagittal, axial, and coronal planes, respectively. The more preoperative posterior pelvic tilt resulted in the more change in the sagittal plane. Further pelvic movement of about 3° in three planes were observed ranging from -11° to 20° after cup placement.Conclusion: This study showed various pelvic tilt and movement during THA. As pelvic tilt directly alters the cup orientation, its changes should be well understood. Improved tools for positioning and holding the pelvis are required.

Original languageEnglish
Pages (from-to)435-440
Number of pages6
JournalModern Rheumatology
Issue number3
Publication statusPublished - May 3 2016

All Science Journal Classification (ASJC) codes

  • Rheumatology


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