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F Gaj - One of the best experts on this subject based on the ideXlab platform.
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Posterior Pelvic Tilt is a risk factor for rectal prolapse a propensity score matching analysis
Techniques in Coloproctology, 2020Co-Authors: C Cantiani, D Sgamma, E Grossi, D Sacca, O R Meli, Quirino Lai, F GajAbstract:BACKGROUND There is little evidence about possible effects of Pelvic anatomical characteristics on proctological complications. The aim of our study was to investigate the potential correlation between sagittal Pelvic position and rectal prolapse. METHODS A study was conducted on a proctology patients and patients without any specific history of proctological disorders who were divided into two groups according to the presence or the absence of rectal prolapse. In all cases, the Pelvic angle was measured with a Pelvic goniometer and categorized as Posterior ( 15°). To minimize effects of potential confounders in the analysis, 3:1 nearest neighbor propensity score matching (PSM) method was implemented using age, sex, and diagnose of rectal disorders as confounding variables. RESULTS Among the 143 screened patients, Posterior Tilt was more frequent in the 19 patients with rectal prolapse than in those without prolapse (42 vs. 18%; p = 0.027). This result was also confirmed in the post-PSM analysis (42 vs. 14%; p = 0.036) using 35 propensity score (PS)-matched controls compared with the rectal prolapse group. Posterior Tilt was associated with an increased risk of prolapse in both the unmatched population (odds ratio = 3.37; p = 0.020) and PS-matched subset (odds ratio = 4.36; p = 0.028). CONCLUSIONS A Posterior Pelvic angle was more frequently associated with the diagnosis of rectal prolapse. In both the entire population and in the PS-matched subset, Posterior Tilt was a significant risk factor for rectal prolapse. The easy-to-do investigation of the Pelvic angle can provide several benefits in terms of rectal prolapse prevention and more precise management of post-surgical prolapse recurrence.
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Posterior Pelvic Tilt is a risk factor for rectal prolapse a propensity score matching analysis
Techniques in Coloproctology, 2020Co-Authors: C Cantiani, D Sgamma, E Grossi, D Sacca, O R Meli, Quirino Lai, F GajAbstract:There is little evidence about possible effects of Pelvic anatomical characteristics on proctological complications. The aim of our study was to investigate the potential correlation between sagittal Pelvic position and rectal prolapse. A study was conducted on a proctology patients and patients without any specific history of proctological disorders who were divided into two groups according to the presence or the absence of rectal prolapse. In all cases, the Pelvic angle was measured with a Pelvic goniometer and categorized as Posterior ( 15°). To minimize effects of potential confounders in the analysis, 3:1 nearest neighbor propensity score matching (PSM) method was implemented using age, sex, and diagnose of rectal disorders as confounding variables. Among the 143 screened patients, Posterior Tilt was more frequent in the 19 patients with rectal prolapse than in those without prolapse (42 vs. 18%; p = 0.027). This result was also confirmed in the post-PSM analysis (42 vs. 14%; p = 0.036) using 35 propensity score (PS)-matched controls compared with the rectal prolapse group. Posterior Tilt was associated with an increased risk of prolapse in both the unmatched population (odds ratio = 3.37; p = 0.020) and PS-matched subset (odds ratio = 4.36; p = 0.028). A Posterior Pelvic angle was more frequently associated with the diagnosis of rectal prolapse. In both the entire population and in the PS-matched subset, Posterior Tilt was a significant risk factor for rectal prolapse. The easy-to-do investigation of the Pelvic angle can provide several benefits in terms of rectal prolapse prevention and more precise management of post-surgical prolapse recurrence.
C Cantiani - One of the best experts on this subject based on the ideXlab platform.
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Posterior Pelvic Tilt is a risk factor for rectal prolapse a propensity score matching analysis
Techniques in Coloproctology, 2020Co-Authors: C Cantiani, D Sgamma, E Grossi, D Sacca, O R Meli, Quirino Lai, F GajAbstract:BACKGROUND There is little evidence about possible effects of Pelvic anatomical characteristics on proctological complications. The aim of our study was to investigate the potential correlation between sagittal Pelvic position and rectal prolapse. METHODS A study was conducted on a proctology patients and patients without any specific history of proctological disorders who were divided into two groups according to the presence or the absence of rectal prolapse. In all cases, the Pelvic angle was measured with a Pelvic goniometer and categorized as Posterior ( 15°). To minimize effects of potential confounders in the analysis, 3:1 nearest neighbor propensity score matching (PSM) method was implemented using age, sex, and diagnose of rectal disorders as confounding variables. RESULTS Among the 143 screened patients, Posterior Tilt was more frequent in the 19 patients with rectal prolapse than in those without prolapse (42 vs. 18%; p = 0.027). This result was also confirmed in the post-PSM analysis (42 vs. 14%; p = 0.036) using 35 propensity score (PS)-matched controls compared with the rectal prolapse group. Posterior Tilt was associated with an increased risk of prolapse in both the unmatched population (odds ratio = 3.37; p = 0.020) and PS-matched subset (odds ratio = 4.36; p = 0.028). CONCLUSIONS A Posterior Pelvic angle was more frequently associated with the diagnosis of rectal prolapse. In both the entire population and in the PS-matched subset, Posterior Tilt was a significant risk factor for rectal prolapse. The easy-to-do investigation of the Pelvic angle can provide several benefits in terms of rectal prolapse prevention and more precise management of post-surgical prolapse recurrence.
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Posterior Pelvic Tilt is a risk factor for rectal prolapse a propensity score matching analysis
Techniques in Coloproctology, 2020Co-Authors: C Cantiani, D Sgamma, E Grossi, D Sacca, O R Meli, Quirino Lai, F GajAbstract:There is little evidence about possible effects of Pelvic anatomical characteristics on proctological complications. The aim of our study was to investigate the potential correlation between sagittal Pelvic position and rectal prolapse. A study was conducted on a proctology patients and patients without any specific history of proctological disorders who were divided into two groups according to the presence or the absence of rectal prolapse. In all cases, the Pelvic angle was measured with a Pelvic goniometer and categorized as Posterior ( 15°). To minimize effects of potential confounders in the analysis, 3:1 nearest neighbor propensity score matching (PSM) method was implemented using age, sex, and diagnose of rectal disorders as confounding variables. Among the 143 screened patients, Posterior Tilt was more frequent in the 19 patients with rectal prolapse than in those without prolapse (42 vs. 18%; p = 0.027). This result was also confirmed in the post-PSM analysis (42 vs. 14%; p = 0.036) using 35 propensity score (PS)-matched controls compared with the rectal prolapse group. Posterior Tilt was associated with an increased risk of prolapse in both the unmatched population (odds ratio = 3.37; p = 0.020) and PS-matched subset (odds ratio = 4.36; p = 0.028). A Posterior Pelvic angle was more frequently associated with the diagnosis of rectal prolapse. In both the entire population and in the PS-matched subset, Posterior Tilt was a significant risk factor for rectal prolapse. The easy-to-do investigation of the Pelvic angle can provide several benefits in terms of rectal prolapse prevention and more precise management of post-surgical prolapse recurrence.
Nobuhiko Sugano - One of the best experts on this subject based on the ideXlab platform.
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Posterior Pelvic Tilt from supine to standing in patients with symptomatic developmental dysplasia of the hip
Journal of Orthopaedic Research, 2020Co-Authors: Tetsuro Tani, Masaki Takao, Keisuke Uemura, Yoshito Otake, Hidetoshi Hamada, Wataru Ando, Yoshinobu Sato, Nobuhiko SuganoAbstract:Pelvic sagittal inclination (PSI) significantly affects the femoral head coverage by the acetabulum in patients with developmental dysplasia of the hip (DDH), while no reports have quantified PSI in DDH patients in the supine and standing positions. Furthermore, little is known about how PSI changes after periacetabular osteotomies. Herein, PSI in the supine and standing positions was quantified in DDH patients preoperatively and postoperatively. Twenty-five patients with DDH who had undergone periacetabular osteotomies were analyzed. The preoperative PSI and the PSI 2 years after surgery were measured in the supine and standing positions using the image registration technique between radiographs and computed tomographic images. The percentage of patients who showed PSI changes of more than 10° from the supine to the standing position was quantified. PSI changed 8.2 ± 5.0° Posteriorly from the supine to the standing position during the preoperative period. Posterior Pelvic Tilt of more than 10° was found in nine cases (36%). Two years after periacetabular osteotomies, the postural PSI change was 7.1 ± 3.9° Posteriorly. When the preoperative and postoperative PSI values were compared, PSI in the standing position did not differ (p = 0.20). Similarly, the amount of PSI change from the supine to standing position was not significantly different (p = 0.26). In conclusion, Posterior Pelvic Tilt in the standing position was found preoperatively in symptomatic DDH patients, and it remained for 2 years after periacetabular osteotomies. This postural change in PSI does not seem to influence the outcome of periacetabular osteotomy. However, during preoperative planning, surgeons should recognize that acetabular anteversion or anterior acetabular coverage differs between the supine and standing positions in some patients with DDH. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:578-587, 2020.
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hip range of motion during daily activities in patients with Posterior Pelvic Tilt from supine to standing position
Journal of Orthopaedic Research, 2015Co-Authors: Satoru Tamura, Masaki Takao, Hidenobu Miki, Kosuke Tsuda, Asaki Hattori, Naoki Suzuki, Kazuo Yonenobu, Nobuhiko SuganoAbstract:In most patients with hip disorders, the anterior Pelvic plane (APP) sagittal Tilt does not change from supine to standing position. However, in some patients, APP sagittal Tilt changes more than 10° Posteriorly from supine to standing position. The purpose of this study was to both examine APP sagittal Tilt and investigate the hip flexion and extension range of motion (ROM) required during daily activities in these atypical patients. Patient-specific 4-dimensional (4D) motion analysis was performed for 50 hips from 44 patients who had undergone total hip arthroplasty. All patients divided into two categories, such as atypical patients for whom the pelvis Tilted more than 10° Posteriorly from supine to standing position preoperatively (19 hips from 18 patients) and the remaining typical patients (31 hips from 26 patients). The required hip flexion and extension angles did not differ significantly between atypical patients and typical patients. In conclusion, the hip flexion ROM during deep bending activities and hip extension ROM during extension activities required in those atypical patients with Pelvic Tilt more than 10° backward from supine to standing position did not shift in the direction of extension. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:542–547, 2015.
Yukihide Iwamoto - One of the best experts on this subject based on the ideXlab platform.
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late anterior dislocation due to Posterior Pelvic Tilt in total hip arthroplasty
The Open Orthopaedics Journal, 2016Co-Authors: Hiroki Kobayashi, Yasuharu Nakashima, Takuaki Yamamoto, Goro Motomura, Masayuki Kanazawa, Kenji Takagishi, Yukihide IwamotoAbstract:BACKGROUND Excessive Pelvic Tilt may be one of the factors leading to instability in total hip arthroplasty (THA), even when the acetabular cup is placed properly. To our knowledge, only a few studies have described late anterior dislocation due to Posterior Pelvic Tilt. We present 3 cases with late anterior dislocations possibly due to Posterior Pelvic Tilt. CASES PRESENTATIONS Case-1: An 84-years-old woman fell and presented with an anterior dislocation 12-years after THA. Her pelvis had Tilted to approximately 30° Posteriorly in a supine position. After conservative treatment, she presented with 10 recurrent anterior dislocations. She had thoracolumbar kyphosis due to multiple compression fractures. Revision with anterior placement of an elevated liner and a 32-mm head corrected the dislocation, and no further dislocations occurred. Case-2: A 78-years-old woman fell and presented with an anterior dislocation 4-years after THA. Her Posterior Pelvic Tilt had increased 23° due to a lumbar compression fracture. Revision by decreasing the cup anteversion was performed, but recurrent Posterior dislocations occurred. Owing to her worsened general condition, further treatment was abandoned. Case-3: A 79-years-old woman twisted her body and presented an anterior dislocation 3-years after THA. After manual reduction and conservative treatment, the dislocation recurred. Her Posterior Pelvic Tilt had increased 16°. CONCLUSION Although minor trauma triggered the anterior instability in these patients, the underlying pathomechanism existed in the progressive Pelvic Posterior Tilt due to thoracolumbar kyphosis. As longer life expectancy as well as implant survivorship is predicted, attention must be paid to the change of Pelvic Tilt in elderly patients.
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Pelvic Tilt and movement during total hip arthroplasty in the lateral decubitus position
Modern Rheumatology, 2016Co-Authors: Masayuki Kanazawa, Yasuharu Nakashima, Takuaki Yamamoto, Goro Motomura, Masanobu Ohishi, Satoshi Hamai, Junichi Fukushi, Takahiro Ushijima, Daisuke Hara, Yukihide IwamotoAbstract:AbstractObjectives: Total hip arthroplasty (THA) is often performed in the lateral decubitus (lateral) position. In this position, the pelvis may have various degrees of Tilt leading to implant malposition. We sought to quantify the Pelvic Tilt in lateral position and further Pelvic movement during surgery.Methods: In 95 cases with primary THA, three-dimensional Pelvic Tilts were quantified by superimposing images reconstructed from CT data onto antero-Posterior radiographs taken in lateral position at set-up and after cup placement. Pelvises were fixed with a device compressing anterior superior iliac spines and sacrum.Results: Various degrees of Pelvic Tilt occurred compared to the supine position; sagittal: −3.1° (−25.5° to 10.2°), axial: 3.9° (−8.4° to 17°), coronal: 0.9° (−11.9° to 13.2°). Absolute changes more than 5° were observed 43%, 47%, and 12% in the sagittal, axial, and coronal planes, respectively. The more preoperative Posterior Pelvic Tilt resulted in the more change in the sagittal plane....
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kinematic analysis of healthy hips during weight bearing activities by 3d to 2d model to image registration technique
BioMed Research International, 2014Co-Authors: Daisuke Hara, Yasuharu Nakashima, Masayuki Kanazawa, Satoshi Hamai, Hidehiko Higaki, Satoru Ikebe, Takeshi Shimoto, Masanobu Hirata, Yusuke Kohno, Yukihide IwamotoAbstract:Dynamic hip kinematics during weight-bearing activities were analyzed for six healthy subjects. Continuous X-ray images of gait, chair-rising, squatting, and twisting were taken using a flat panel X-ray detector. Digitally reconstructed radiographic images were used for 3D-to-2D model-to-image registration technique. The root-mean-square errors associated with tracking the pelvis and femur were less than 0.3 mm and 0.3° for translations and rotations. For gait, chair-rising, and squatting, the maximum hip flexion angles averaged 29.6°, 81.3°, and 102.4°, respectively. The pelvis was Tilted anteriorly around 4.4° on average during full gait cycle. For chair-rising and squatting, the maximum absolute value of anterior/Posterior Pelvic Tilt averaged 12.4°/11.7° and 10.7°/10.8°, respectively. Hip flexion peaked on the way of movement due to further anterior Pelvic Tilt during both chair-rising and squatting. For twisting, the maximum absolute value of hip internal/external rotation averaged 29.2°/30.7°. This study revealed activity dependent kinematics of healthy hip joints with coordinated Pelvic and femoral dynamic movements. Kinematics’ data during activities of daily living may provide important insight as to the evaluating kinematics of pathological and reconstructed hips.
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effects of Posterior Pelvic Tilt on anterior instability in total hip arthroplasty a parametric experimental modeling evaluation
Clinical Biomechanics, 2013Co-Authors: Taishi Sato, Yasuharu Nakashima, Akinobu Matsushita, Masanori Fujii, Yukihide IwamotoAbstract:Abstract Background Anterior dislocation is one of the concerns of patients with Posterior Pelvic Tilt undergoing total hip arthroplasty. This study aimed to evaluate the magnitude of Posterior Pelvic Tilt constituting a risk for anterior dislocation by measuring the range of motion until impingement and dislocation under various Pelvic Tilt. Methods Using a jig mounted prosthetic hip model, the ranges of external rotation at extension and internal rotation at flexion until reaching dislocation were tested. The site of impingement prior to dislocation was also recorded. Posterior Pelvic Tilt and the cup version were changed with 10° increments from 0° to 40° and from 10° retroversion to 30° anteversion, respectively. Effects of increasing femoral offset were also tested. We defined a required range of motion as having 30° external rotation at extension and 40° internal rotation at 90° flexion. Findings External rotation decreased in a Posterior Pelvic Tilt-dependent manner. In the case with more than 20° Posterior Pelvic Tilt, available external rotation extended beyond required range with the cup anteversion of 20°. Decreasing cup anteversion improved external rotation, however, internal rotation decreased simultaneously. In the case with Posterior Pelvic Tilt more than 20°, only cup anteversion with 0° or 10° satisfied the required range of motion. A + 4 mm horizontal offset improved external rotation by 10° with delaying bony impingement. Interpretation More than 20° of Posterior Pelvic Tilt may cause anterior instability and diminish the optimal range of cup version. Increasing the femoral offset improved external rotation without reducing internal rotation.
E Grossi - One of the best experts on this subject based on the ideXlab platform.
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Posterior Pelvic Tilt is a risk factor for rectal prolapse a propensity score matching analysis
Techniques in Coloproctology, 2020Co-Authors: C Cantiani, D Sgamma, E Grossi, D Sacca, O R Meli, Quirino Lai, F GajAbstract:BACKGROUND There is little evidence about possible effects of Pelvic anatomical characteristics on proctological complications. The aim of our study was to investigate the potential correlation between sagittal Pelvic position and rectal prolapse. METHODS A study was conducted on a proctology patients and patients without any specific history of proctological disorders who were divided into two groups according to the presence or the absence of rectal prolapse. In all cases, the Pelvic angle was measured with a Pelvic goniometer and categorized as Posterior ( 15°). To minimize effects of potential confounders in the analysis, 3:1 nearest neighbor propensity score matching (PSM) method was implemented using age, sex, and diagnose of rectal disorders as confounding variables. RESULTS Among the 143 screened patients, Posterior Tilt was more frequent in the 19 patients with rectal prolapse than in those without prolapse (42 vs. 18%; p = 0.027). This result was also confirmed in the post-PSM analysis (42 vs. 14%; p = 0.036) using 35 propensity score (PS)-matched controls compared with the rectal prolapse group. Posterior Tilt was associated with an increased risk of prolapse in both the unmatched population (odds ratio = 3.37; p = 0.020) and PS-matched subset (odds ratio = 4.36; p = 0.028). CONCLUSIONS A Posterior Pelvic angle was more frequently associated with the diagnosis of rectal prolapse. In both the entire population and in the PS-matched subset, Posterior Tilt was a significant risk factor for rectal prolapse. The easy-to-do investigation of the Pelvic angle can provide several benefits in terms of rectal prolapse prevention and more precise management of post-surgical prolapse recurrence.
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Posterior Pelvic Tilt is a risk factor for rectal prolapse a propensity score matching analysis
Techniques in Coloproctology, 2020Co-Authors: C Cantiani, D Sgamma, E Grossi, D Sacca, O R Meli, Quirino Lai, F GajAbstract:There is little evidence about possible effects of Pelvic anatomical characteristics on proctological complications. The aim of our study was to investigate the potential correlation between sagittal Pelvic position and rectal prolapse. A study was conducted on a proctology patients and patients without any specific history of proctological disorders who were divided into two groups according to the presence or the absence of rectal prolapse. In all cases, the Pelvic angle was measured with a Pelvic goniometer and categorized as Posterior ( 15°). To minimize effects of potential confounders in the analysis, 3:1 nearest neighbor propensity score matching (PSM) method was implemented using age, sex, and diagnose of rectal disorders as confounding variables. Among the 143 screened patients, Posterior Tilt was more frequent in the 19 patients with rectal prolapse than in those without prolapse (42 vs. 18%; p = 0.027). This result was also confirmed in the post-PSM analysis (42 vs. 14%; p = 0.036) using 35 propensity score (PS)-matched controls compared with the rectal prolapse group. Posterior Tilt was associated with an increased risk of prolapse in both the unmatched population (odds ratio = 3.37; p = 0.020) and PS-matched subset (odds ratio = 4.36; p = 0.028). A Posterior Pelvic angle was more frequently associated with the diagnosis of rectal prolapse. In both the entire population and in the PS-matched subset, Posterior Tilt was a significant risk factor for rectal prolapse. The easy-to-do investigation of the Pelvic angle can provide several benefits in terms of rectal prolapse prevention and more precise management of post-surgical prolapse recurrence.