Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Clin Orthop Relat Res. 2011 Feb;469(2):412-6. doi: 10.1007/s11999-010-1523-1.
Several studies have reported that the transverse acetabular ligament (TAL) can be used to orient the acetabular component during total hip arthroplasty and that it can be identified in nearly all patients.
QUESTIONS/PURPOSES: We attempted to determine how often the TAL could be identified during primary THA and its accuracy as a guide for acetabular component positioning.
In a prospective series of 63 patients (64 hips) undergoing primary THA, two surgeons attempted to identify the TAL and, if it was found, to use it for acetabular component orientation. Patients in whom the TAL was identified served as the study group and the ligament was used for cup orientation in those patients; the remaining patients in whom the ligament could not be identified served as a control group and had free-hand cup positioning. Anteversion was determined by radiographic measurement from true lateral views.
The TAL was identified in only 30 hips (47%) and was more likely to be found in patients who did not have inferior acetabular osteophytes. Acetabular position was not improved using this ligament for reference.
The TAL could not be routinely identified at surgery and when used for cup orientation it was no more accurate for cup positioning than free-hand technique.
多项研究报告称，横行髋臼韧带（TAL）可用于指导全髋关节置换术中髋臼假体的安放位置，几乎所有患者都可以识别该韧带。
问题/目的：我们试图确定在初次全髋关节置换术中 TAL 可被识别的频率及其作为髋臼假体定位的指导的准确性。
在一项前瞻性的 63 例（64 髋）初次全髋关节置换术患者的系列研究中，两位外科医生试图识别 TAL，如果发现该韧带，就用它来指导髋臼假体的方向。识别出 TAL 的患者为研究组，在这些患者中使用该韧带进行髋臼杯的定位；其余未能识别出 TAL 的患者为对照组，采用徒手定位髋臼杯。前倾角通过从真正的侧位片上的放射学测量来确定。
仅在 30 髋（47%）中识别出 TAL，并且在没有髋臼下骨赘的患者中更有可能发现该韧带。使用该韧带作为参考并没有改善髋臼的位置。
TAL 在手术中不能常规识别，并且当用于髋臼杯定位时，其定位准确性并不优于徒手技术。
