International Orthopaedics

, Volume 42, Issue 4, pp 769–775 | Cite as

A retrospective study on the relationship between altered native acetabular angle and vertical implant malpositioning

  • Jorge Rojas
  • Maria Bautista
  • Guillermo Bonilla
  • Omar Amado
  • Elina Huerfano
  • Daniel Monsalvo
  • Adolfo Llinás
  • José Navas
Original Paper



Acetabular cup positioning in extreme angles of vertical position affects both stability and long-term survivorship of total hip arthroplasty. The purpose of this study is to determine whether native Sharp’s angle is associated with an increased abduction angle of the acetabular component.


Consecutive patients who underwent primary total hip replacement between February 2012 and August 2015 were included. Vertical positioning of acetabular implant in the antero-posterior post-operative radiographs were measured. The proportion of implants positioned outside the safe zone (40° ± 10°) was calculated and through a multivariate analysis, Sharp’s angle and other factors possibly associated with cup malpositioning were evaluated.


Five hundred twenty-eight hip arthroplasties were analyzed. Prevalence of cup malpositioning was 7.6% and 25 patients had an altered native acetabular angle. An altered pre-operative Sharp’s angle was associated with a higher risk of vertical malpositioning of the acetabular component (OR 2.51 IC 95%: 1.17–5.39) (p = 0.02). Body mass index, surgeon’s volume, size of the implant, gender, pre-operative diagnose and age, were not associated with the position of the cup.


The alteration of the Sharp’s angle as an indicator of hip dysplasia in native hips increases the odds of acetabular cup malpositioning. Other factors explored did not correlate with the position of the acetabular prosthesis. Systematic assessment of Sharp’s angle should be included in the pre-operative planning of primary hip arthroplasty.


Acetabulum Artrhoplasty, replacement, hip Hip prosthesis implantation Acetabular cup positioning 


Compliance with ethical standards

Conflict of interest

Dr. Bautista has received other financial support from DePuy Synthes (Orthopedics) and Grunenthal, outside this work. Dr. Bonilla has participated as a paid speaker for Boehringer-Ingelheim, Pfizer, Bristol-Myers-Squibb, DePuy Synthes (Orthopedics) and Stryker; has received other financial support from DePuy Synthes (Orthopedics) and Grunenthal, outside this work. Dr. Llinás has received royalties from Innomed; has participated as a paid speaker for Zimmer, Bayer, Covidien, Ethicon, Pfizer, Novonordisk, Baxter, 3 M, Biotest and Procaps; has participated as a paid consultant for Ethicon, Zimmer and Bayer, outside this work. Dr. Rojas has nothing to disclose. Dr. Amado has nothing to disclose. Dr. Huerfano has nothing to disclose. Dr. Monsalvo has nothing to disclose. Dr. Navas has nothing to disclose.

Ethical approval

The Institutional Review Board approved the development of this research study. For this type of study formal consent is not required. This article does not contain any experimental intervention with human participants or animals performed by any of the authors.


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Copyright information

© SICOT aisbl 2017

Authors and Affiliations

  • Jorge Rojas
    • 1
  • Maria Bautista
    • 2
  • Guillermo Bonilla
    • 3
  • Omar Amado
    • 1
  • Elina Huerfano
    • 1
  • Daniel Monsalvo
    • 1
  • Adolfo Llinás
    • 3
  • José Navas
    • 1
  1. 1.Department of Orthopedics and TraumatologyHospital Universitario Fundación Santa Fe de BogotáBogotáColombia
  2. 2.Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santa Fe de Bogotá, School of MedicineUniversidad del RosarioBogotáColombia
  3. 3.Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santa Fe de Bogotá, School of Medicine, Universidad de los Andes. School of MedicineUniversidad del RosarioBogotáColombia

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