Lewinnek Safe Zone References are Frequently Misquoted

Arthroplasty Today

Ameer Elbuluk, MD¹  Seth A. Jerabek, MD¹  Jonathan M. Vigdorchik, MD¹  Jim Pierrepont, PhD²  Aonnicha Burapachaisri, BS³  Edem Abotsi, BS³  Aaron J. Buckland, MBBS, FRACS³ 

[1] Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA;Chief Innovation Officer, Corin Group, New South Wales, Australia;Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA;

关键词: Total hip arthroplasty;    Lewinnek;    Safe zone;    Anteversion;    Inclination;    Anterior pelvic plane;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Optimal acetabular component orientation in total hip arthroplasty (THA) is a necessity in achieving a stable implant. Although there has been considerable debate in the literature concerning the safe zone, to date, there has not been any review to determine if these references are consistent with the definition applied by Lewinnek et al. in 1978. Therefore, this article aims to examine the available literature in the PubMed database to determine how often a correct reference to the safe zone as defined by Lewinnek was applied to discussions regarding THA. Methods: A search for literature in the PubMed database was performed for articles from 1978 to 2019. Search criteria included terms ‘Lewinnek,’ ‘safe zone,’ and ‘total hip arthroplasty.’ Exclusions included abstract-only articles, non-English articles, articles unrelated to THA, and those lacking full content. Results: A review of literature yielded 147 articles for inclusion. Overall, only 11% (17) cited the Lewinnek article correctly. Forty-five percent (66) of articles referenced measurements in the supine position, 18% (26) referenced other positions, and 37% (55) did not specify. Nineteen percent (28) reported measurements of the acetabular cup orthogonal to the anterior pelvic plane, while 73% (108) did not, and 7% (11) did not specify. Twenty-three percent (34) measured from computed tomography scans instead of other methods. Conclusions: In the discussion of the safe zone regarding THA, only 11% of articles listed are consistent with the definition established by Lewinnek. This warrants further investigation into a consistent application of the term and its implications for THA implant stability and dislocation rates.

【 授权许可】

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