Baylor College of Medicine, Houston, Texas, USA.
J Arthroplasty. 2010 Dec;25(8):1275-81.e1. doi: 10.1016/j.arth.2009.10.007. Epub 2009 Dec 21.
Impingement, both prosthetic and bony, precedes the vast majority of dislocations after total hip arthroplasty and may adversely impact component wear. Reconstructed computer hip models of 8 subjects were used to evaluate hip range of motion for activities of daily living (ADLs) associated with posterior instability and anterior instability. Variables examined included acetabular position, femoral offset, and head size. The majority of flexion ADLs (associated with posterior instability) encountered prosthetic impingement, whereas extension ADLs demonstrated bony impingement with the 45/20 cup placement position. Cup placement in natural anteversion and adduction allowed normal joint motion in anterior and posterior impinging activities. Insufficient femoral offset and smaller head size negatively impacted range of motion. Any anterior cup and posterior cup protrusions greater than 5 mm should be avoided.
撞击，无论是假体还是骨，都先于大多数全髋关节置换术后脱位，并可能对部件磨损产生不利影响。使用 8 名受试者的重建计算机髋关节模型来评估与后不稳定和前不稳定相关的日常活动（ADL）的髋关节活动范围。检查的变量包括髋臼位置、股骨偏心距和股骨头大小。大多数与后不稳定相关的屈曲 ADL 遇到假体撞击，而伸展 ADL 则在 45/20 杯放置位置显示骨撞击。在自然前倾角和内收位放置杯可允许在前部和后部撞击活动中正常关节运动。股骨偏心距不足和股骨头较小会对运动范围产生负面影响。应避免任何前杯和后杯突出超过 5 毫米。
