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Dr. Juan Suarez from Baptist Health South Florida shares his perspectives on Cup Positioning at AHF 2024. Dr. Suarez was attracted to the anterior approach because it allowed using fluoroscopy during surgery to ensure accurate implant positioning, avoiding surprises in recovery Accurate cup positioning is important, as 20% of hip revision surgeries are done for instability issues according to AJR data He helped develop the "Cuptomizee" technology to determine pelvic tilt and predict cup position in sitting and standing Cuptomize uses standing/supine AP and lateral x-rays to calculate pelvic tilt and desired cup angles Intraoperatively, it overlays the preop plan on live fluoro to guide optimal cup positioning for that patient's pelvic tilt The goal is typically 20-30° anteversion when standing, and at least 20° anteversion when sitting The anterior approach may mitigate instability risk in patients with altered spinopelvic dynamics based on recent studies There are sometimes tradeoffs in cup positioning vs. bony coverage that require judgement calls Pelvic tilt can change after correcting contractures, so assumptions pre/post-op may differ Both anteversion and inclination angles impact risk of anterior vs posterior instability For more information about the 2024 Anterior Hip Foundation annual event, visit: www.anteriorhipfoundation.com