Patients with abnormal spinopelvic mobility are at increased risk for instability. Measuring the change in sacral slope (ΔSS) can help determine spinopelvic mobility preoperatively. Sacral slope (SS) should decrease at least 10° to demonstrate adequate posterior pelvic tilt. There is potential for different ΔSS measurements in the same patient based on sitting posture. The purpose of this study was to determine the effect of sitting posture on the ΔSS in patients undergoing total hip arthroplasty (THA). In total, 51 patients undergoing THA were reviewed to quantify the variability in preoperative spinopelvic mobility when measuring two different sitting positions using SS for planning.Aims
Methods
Patients with abnormal spinopelvic mobility are at increased risk for hip instability. Measuring the change in sacral slope (ΔSS) with standing and seated lateral radiographs is commonly used to determine spinopelvic mobility pre-operatively. Sacral slope should decrease at least 10 degrees to demonstrate adequate accommodation. Accommodation of <10 deg necessitates acetabular component position change or use of a dual mobility implant. There is potential for different ΔSS measurements in the same patient based on sitting posture. 78 patients who underwent THA were reviewed to quantify the variability in pre-operative spinopelvic mobility when two different seated positions (relaxed sitting v. pre-rise sitting) were used in the same patient.Introduction
Methods
Studies are being done comparing 1-stage vs. 2-stage protocols for PJI. 1-stage protocols take an extended period of time requiring 2 separate preps and sets of instruments in order to ensure optimal sterility. While intraoperative service time is one part of the reimbursement algorithm, reimbursement has lagged behind for single stage treatment. If 1-stage results are acceptable, but not reimbursed appropriately, surgeons may be discouraged from managing PJI in a 1-stage fashion. We ask, “What is the reimbursement and intraoperative service time for 1-stage procedures compared to primary surgery?” Relative Value Unit's (RVU's), reimbursement and operative time for 50 PJI procedures were reviewed and compared to 250 primary (1°) THA and 250 primary (1°) TKA by four surgeons. Coding was done per AAOS guidelines.Introduction
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