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THA Universal 2

Cup only workflow

The good orientation

Pelvis orientation is the basis for the navigation of the cup component. There are different ways to orient the pelvis: Either the Anterior Pelvic Plane (APP) defined by both spinae iliaca anterior superior (ASIS) and the symphysis or the Acetabular Center Axis (ACA).

Navigation plays an important role in achieving safe surgical procedures and implantation results. OrthoPilot® helps to keep everything in view and results are documented.

Screenshot Cup only navigation software hip arthroplasty

Acetabular center axis (ACA)

The ACA reference is patient-specific independent of variations in anatomy or pelvic position. The surgeon gets the orientation of the reamer or cup impactor in relation to the Acetabular Center Axis and can determine the cup orientation and position in relation to the original hip center. The new cup center should preferably be within 4 mm of the ACA for a good stability and minimal impingement risk. Desired aim for cup inclination is 0° whereas the anteversion should be kept within ± 5°. ACA referencing relies on landmarks palpated around the acetabular rim. The use of the ACA for pelvis orientation is especially recommended for THA in lateral patient position.

Anterior pelvic plane (APP)

The APP remains the most used reference for the navigation of cup inclination and anteversion. The APP is defined by the anterior superior spines and the symphysis. Based on this plane, the cup can be oriented according to the pre-operative planning. The most important point to get an accurate cup orientation is a proper palpation of the bony landmarks.