Department of Trauma Surgery, University Hospital Essen, Essen, Germany.
J Orthop Surg Res. 2012 Jun 11;7:25. doi: 10.1186/1749-799X-7-25.
Aseptic loosening is one of the greatest problems in hip replacement surgery. The rotation center of the hip is believed to influence the longevity of fixation. The aim of this study was to compare the influence of cemented and cementless cup fixation techniques on the position of the center of rotation because cemented cup fixation requires the removal of more bone for solid fixation than the cementless technique.
We retrospectively compared pre- and post-operative positions of the hip rotation center in 25 and 68 patients who underwent artificial hip replacements in our department in 2007 using cemented or cementless cup fixation, respectively, with digital radiographic image analysis.
The mean horizontal and vertical distances between the rotation center and the acetabular teardrop were compared in radiographic images taken pre- and post-operatively. The mean horizontal difference was -2.63 mm (range: -11.00 mm to 10.46 mm, standard deviation 4.23 mm) for patients who underwent cementless fixation, and -2.84 mm (range: -10.87 to 5.30 mm, standard deviation 4.59 mm) for patients who underwent cemented fixation. The mean vertical difference was 0.60 mm (range: -20.15 mm to 10.00 mm, standard deviation 3.93 mm) and 0.41 mm (range: -9.26 mm to 6.54 mm, standard deviation 3.58 mm) for the cementless and cemented fixation groups, respectively. The two fixation techniques had no significant difference on the position of the hip rotation center in the 93 patients in this study.
The hip rotation center was similarly restored using either the cemented or cementless fixation techniques in this patient cohort, indicating that the fixation technique itself does not interfere with the position of the center of rotation. To completely answer this question further studies with more patients are needed.
无菌性松动是髋关节置换手术中最大的问题之一。髋关节的旋转中心被认为会影响固定的耐久性。本研究的目的是比较骨水泥固定和非骨水泥固定杯固定技术对旋转中心位置的影响，因为骨水泥固定杯固定需要去除更多的骨来实现牢固固定，而非骨水泥固定技术则不需要。
我们回顾性比较了 2007 年在我院接受人工髋关节置换术的 25 例和 68 例患者的髋关节旋转中心术前和术后的位置，分别采用骨水泥固定和非骨水泥固定杯固定，并进行数字放射影像分析。
比较了使用非骨水泥固定的患者（n=25）和使用骨水泥固定的患者（n=68）在术前和术后放射影像上旋转中心与髋臼泪滴之间的水平和垂直距离。非骨水泥固定组的平均水平差值为-2.63mm（范围：-11.00mm 至 10.46mm，标准差 4.23mm），骨水泥固定组的平均水平差值为-2.84mm（范围：-10.87mm 至 5.30mm，标准差 4.59mm）。非骨水泥固定组的平均垂直差值为 0.60mm（范围：-20.15mm 至 10.00mm，标准差 3.93mm），骨水泥固定组的平均垂直差值为 0.41mm（范围：-9.26mm 至 6.54mm，标准差 3.58mm）。在这项研究的 93 例患者中，两种固定技术对髋关节旋转中心的位置没有显著差异。
在本患者队列中，使用骨水泥固定或非骨水泥固定技术均能相似地恢复髋关节旋转中心，这表明固定技术本身并不影响旋转中心的位置。要完全回答这个问题，还需要进一步进行更多患者的研究。
