In total hip arthroplasty (THA), the rolling motion of the patient in both the forward and backward directions can easily occur particulary using the posterolateral approach, making it difficult to place the acetabular cup in a suitable angle. We devised a three-dimensional goniometer which consists of three goniometers to assess multi-directional pelvic motion during THA. The purpose of this study is to assess the pelvic motion during THA with posterolateral approach using our device. This prospective study involved 26 THAs in 25 cases. Each patient was placed in a lateral decubitus position on the operating table. A Steinmann-pin was inserted into the illium on the operated side. Our device was attached to the Steinmann-pin. Using this device, we measured the tilt angle of the pelvis in the horizontal plane, frontal plane, and sagittal plane before dislocation and at the time of cup placement. The changes of the tilting angle of each plane were analyzed in the three-dimensional directions. In the horizontal plane, the pelvis tilted forward, averaging 14.35 degrees. In the frontal plane, the pelvis tilted toward the caudal, averaging 0.08 degrees. In the sagittal plane, the pelvis tilted backward averaging 3.96 degrees. Pelvic motion primarily occurred when the Hohman-retractor was used for acetabular exposure.
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