Table 3. Component Positioning Data.
| Study | Design | Surgical approach | Component positioning technique | No. of cases | Cup abduction angle (°) | Cup anteversion angle (°) | Criteria for acceptable cup placement | Cases meeting criteria (%) | Leg length difference (mm) | Offset (mm) | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Abduction | Anteversion | Both | ||||||||||
| Matta et al.23) | Retrospective | Direct anterior | Fluoroscopy | 494 | 42±4 | 19.4±5.2 | Abduction: 35°–50° |
96 | 93 | NR | 3±2 | NR |
| Anteversion: 10°–25° | ||||||||||||
| Rathod et al.11) | Retrospective | Posterior | Freehand | 293 | 41.2±7.0 | 24.0±8.7 | Abduction: 30°–50° |
86 | 77 | NR | NR | NR |
| Anteversion: 10°–30° | ||||||||||||
| Direct anterior learning curve | Fluoroscopy | 96 | 39.3±5.1 | 20.2±6.3 | 95 | 91 | NR | NR | NR | |||
| Direct anterior | Fluoroscopy | 286 | 40.4±4.4 | 13.3±4.0 | 98 | 97 | NR | NR | NR | |||
| Ezzet and McCauley12) | Retrospective | Posterior | X-ray | 200 | 43.7±5.5 | NR | Surgeon-specific abduction angles ranging from 35°–55° |
86 | NR | NR | 1.5±5.6 | NR |
| Leucht et al.13) | Retrospective | Posterior | Freehand | 100 | 40.8±5.0 | 35.3±7.1 | Abduction: 30°–50° |
96 | 58 | 57 | 2.7±5.2 | NR |
| Anteversion: 15°–35° | ||||||||||||
| Direct anterior | Fluoroscopy | 100 | 43.4±5.6 | 25.9±8.2 | 89 | 80 | 73 | 0.7±3.7 | NR | |||
| Hamilton et al.14) | Retrospective | Posterior | Freehand | 100 | 44.3±6.5 | 22.6±6.2 | Abduction: 30°–50° |
79 | 64 | NR | NR | NR |
| Anteversion: 5°–25° | ||||||||||||
| Direct anterior | Fluoroscopy | 100 | 44.2±5.0 | 17.6±4.5 | 90 | 92 | NR | NR | NR | |||
| Goodman et al.15) | Retrospective | Direct anterior | Freehand | 100 | 37.5±7.4 | 24.9±5.5 | Abduction: 30°–50° |
76 | 79 | NR | NR | NR |
| Anteversion: 10°–30° | ||||||||||||
| Fluoroscopy | 100 | 43.2±4.5 | 21.8±4.6 | 94 | 93 | NR | NR | NR | ||||
| Lin et al.16) | Retrospective | Posterior | Freehand | 86 | NR | 18.9 | Abduction: 30°–50° |
85 | 72 | NR | 64% <5 mm difference |
68% <5 mm difference† |
| Anteversion: 5°–25° | ||||||||||||
| Direct anterior | Fluoroscopy | 108 | NR | 22.7 | 96 | 66 | NR | 60% <5 mm difference |
75% <5 mm difference† |
|||
| Penenberg et al.6) | Retrospective | Posterior | X-ray | 369 | 39.5±4.6 | 26.6±4.7 | Abduction: 30°–50° |
97.8 | 97.6 | NR | NR | NR |
| Anteversion: 15°–35° | ||||||||||||
| Bingham et al.17) | Retrospective | Direct anterior | Freehand | 140 | 39.9 | 31.1 | Abduction: 30°–50° |
NR | NR | NR | 0.8 | NR |
| Anteversion: 15°–35° | ||||||||||||
| Fluoroscopy | 125 | 39.4 | 30.2 | NR | NR | NR | 1.1 | NR | ||||
| Gililland et al.18) | Retrospective Comparative | Direct anterior | Fluoroscopy | 60 | NR | NR | Abduction: 30°–50° |
83 | NR | NR | 88% within 10 mm | 67% within 10 mm* |
| Fluoroscopy with grid | 39 | NR | NR | 97 | NR | NR | 100% within 10 mm | 85% within 10 mm* | ||||
| Sariali et al.24) | Prospective RCT | Direct anterior | Freehand | 28 | 43.8±7.7 | 24.8±6.9 | Abduction: 30°–50° |
86 | 61 | 54 | NR | NR |
| Anteversion: 5°–25° | ||||||||||||
| CT-based 3D planning | 28 | 37.6±6.1 | 12.6±6.2 | 86 | 93 | 79 | NR | NR | ||||
| Lass et al.25) | Prospective RCT | Modified transgluteal in supine position | Freehand | 63 | 37.7±5.2 | 17.3±10.4 | Abduction: 30°–50° |
92 | 63 | 56 | 4.4±5.6 | NR |
| Anteversion: 5°–25° | ||||||||||||
| Imageless navigation | 62 | 38.6±3.6 | 19.5±4.6 | 100 | 90 | 90 | 2.7±3.8 | NR | ||||
| Weber et al.19) | Prospective RCT | Anterolateral in lateral decubitus position | Fluoroscopy | 61 | NR | NR | NR | NR | NR | NR | 0.6±4.1 | −0.4±3.9*, 2.1±3.9† |
| Imageless navigation | 55 | NR | NR | NR | NR | NR | 0.4±2.2 | −0.6±1.9*, 0.4±2.7† |
||||
| Redmond et al.26) | Retrospective | Posterior | Robotic-assisted (Mako) | 105 | 40.1±3.4 | 20.9±3.6 | NR | NR | NR | NR | 1.9±2.8 | 0.1±4.4* |
| Direct anterior | 41 | 41.5±5.9 | 22.3±4.8 | NR | NR | NR | 2.3±3.7 | −2.4±4.2* | ||||
| Kalteis et al.27) | Prospective RCT | Modified transgluteal approach in supine position | Freehand | 30 | 43.7±7.3 | 22.2±14.2 | Abduction: 30°–50° |
63 | 70 | 47 | NR | NR |
| Anteversion: 5°–25° | ||||||||||||
| CT-based navigation (VectorVision Hip 3.0) | 30 | 41.6±4.0 | 10.7±5.3 | 100 | 83 | 83 | NR | NR | ||||
| Imageless navigation (VectorVision Hip 3.0 landmark-based module) | 30 | 43.2±4.0 | 15.2±5.5 | 97 | 93 | 93 | NR | NR | ||||
| Domb et al.20) | Retrospective | Posterior | Freehand with alignment guide | 708 | 41.7±5.3 | 21.8±6.1 | Abduction: 30°–50° |
NR | NR | 69 | 3.4±3.0 | 4.7±3.8 |
| Anteversion: 5°–25° | ||||||||||||
| X-ray | 59 | 41.9±7.3 | 19.6±9.0 | NR | NR | 64 | 3.7±2.9 | 3.9±3.3 | ||||
| Robotic-assisted (Mako) | 135 | 40.1±3.3 | 16.9±3.9 | NR | NR | 98 | 3.3±2.5 | 4.3±3.5 | ||||
| Direct anterior | Fluoroscopy | 942 | 42.0±5.1 | 20.4±7.2 | NR | NR | 73 | 2.6±2.5 | 3.5±3.0 | |||
| CT-based navigation (VectorVision Hip 3.0) | 43 | 44.7±2.9 | 14.8±5.1 | NR | NR | 91 | 1.8±1.2 | 3.1±2.6 | ||||
| Robotic-assisted (Mako) | 93 | 40.8±4.9 | 19.4±4.8 | NR | NR | 87 | 3.0±2.6 | 3.9±3.1 | ||||
| Hamilton et al.21) | Prospective RCT | Direct anterior | Fluoroscopy | 100 | 42.3±4.1 | 21.8±3.6 | Abduction: 30°–50° |
98 | 99 | 97 | NR | NR |
| Anteversion: 10°–30° | ||||||||||||
| Fluoroscopy with positioning software | 100 | 40.4±3.5 | 20.8±3.0 | 100 | 99 | 99 | NR | NR | ||||
| Current study | Retrospective | Posterior | Freehand | 100 | 44±6 | 31±6 | Abduction: 35°–55° |
90 | 93 | 83 | 0.3±4.8 | 0.3±6.9 |
| Abduction: 20°–40° | ||||||||||||
| X-ray | 100 | 47±6 | 35±6 | 93 | 81 | 76 | 0.3±3.8 | 1.1±6.6 | ||||
Values are presented as number only, mean±standard deviation, or % only.
NR: not reported, RCT: randomized controlled trial, CT: computed tomography.
*Global offset, †Femoral offset.