Research synthesis of recommended acetabular cup orientations for total hip arthroplasty

Claire L. Harrison, Avril I. Thomson, Steven Cutts, Philip J. Rowe, Philip E. Riches

Research output: Contribution to journalArticlepeer-review

42 Citations (Scopus)
390 Downloads (Pure)


Total Hip Arthroplasty (THA) is regarded as one of the most successful surgical procedures of modern times yet continues to be associated with a small but significant complication rate. Many early failures may be associated with poor component positioning with, in particular, acetabular component orientation dependent on the subjective judgement of the surgeon. In this paper, we compare the manufacturers’ instructions on acetabular cup orientation with the literature-based recommended safety zones, by transforming them onto a single, clinically-relevant framework in which the different reference systems, safety guidelines and current instrumentation surgical techniques can be evaluated. The observed limited consensus between reflects ongoing uncertainty regarding the optimum acetabular component positioning that is probably responsible for a significant number of hip dislocations and early revisions. Our analysis suggests a new safety zone - the Strathclyde Safety Zone, SSZ (30° - 55° inclination and 5° - 30° anteversion) - defined in the operative reference frame, that encompasses other safety zones and which, incidentally, holds the majority of manufacturers’ guideline positions.
Original languageEnglish
Pages (from-to)377–382
Number of pages6
JournalJournal of Arthroplasty
Issue number2
Early online date19 Aug 2013
Publication statusPublished - 1 Feb 2014


  • hip arthroplasty
  • acetabular cup orientations
  • malpositioning
  • correct orientation


Dive into the research topics of 'Research synthesis of recommended acetabular cup orientations for total hip arthroplasty'. Together they form a unique fingerprint.

Cite this