The transverse pelvic plane: A new and practical referenceframe for hip arthroplasty

Abstract

Acetabular orientation is a crucial part of the planning and performance of hip arthroplasty. Currently, most surgeons use the anterior pelvic plane (APP) to orient themselves when navigating the acetabulum, despite the fact that the anterior superior iliac spine (ASIS) of the unaffected side is not accessible in the lateral position. We have identified another plane, the transverse pelvic plane (TPP), relying on both posterior superior iliac spines and the ASIS of the affected side. In a CT-based study, this plane was found to be as reliable as the APP for the orientation of the cup in both anteversion and inclination. The substantial variation in both measurements between patients is documented, and their relation to the "safe zone" is shown. We recommend consideration of the TPP by surgeons who perform arthroplasty in the lateral position. It may reduce operating time and improve accuracy in computer-assisted arthroplasty.