Bonnin Michel P, Archbold Pooler H A, Basiglini Lucas, Fessy Michel H, Beverland David E
Santy Orthopaedic Centre, Lyon, France.
Hip Int. 2012 Jul-Aug;22(4):371-8. doi: 10.5301/HIP.2012.9350.
Acetabular offset (AO) is the distance between the centre of the femoral head and the true floor of the acetabulum. We quantified the AO in normal hips and compared the displacement of the centre of rotation of the hip (CRH) after conventional and anatomical cup implantation during THA. 100 CT-scans of normal hips were analysed before and after simulating implantation of the acetabular component. Mean AO was 30.8 mm ± 3.The medial shift of the CRH was 1.6 mm ± 1.2 with the anatomical and 4.8 mm ± 1.9 with the conventional technique (p<0.0001). Medialisation was greater than 5 mm in 44% of the cases when the conventional technique was used, but occurred in no case when using the anatomical technique. Differences between men and women were significant: 5.6 mm ± 1.6 and 3.5 mm ± 1.7 with the conventional technique; 2.0 mm ± 1.1 and 0.9 mm ± 0.9 with the anatomical technique (p<0.0001 for both measurements). The concept of hip offset cannot be limited to that of the femoral offset. AO widely varies and cannot be neglected. In patients with significant AO, surgeons should pay close attention to the preparation of the acetabulum. This should be done conservatively so that the acetabular cup can be placed anatomically in order to restore the native hip biomechanics.
髋臼偏移（AO）是股骨头中心与髋臼真实底部之间的距离。我们对正常髋关节的AO进行了量化，并比较了全髋关节置换术（THA）中传统髋臼杯和解剖型髋臼杯植入后髋关节旋转中心（CRH）的位移。在模拟髋臼组件植入前后，对100例正常髋关节的CT扫描进行了分析。平均AO为30.8 mm±3。解剖型技术使CRH的内侧移位为1.6 mm±1.2，传统技术为4.8 mm±1.9（p<0.0001）。使用传统技术时，44%的病例内侧移位大于5 mm，但使用解剖型技术时无一例出现这种情况。男性和女性之间的差异显著：传统技术下分别为5.6 mm±1.6和3.5 mm±1.7；解剖型技术下分别为2.0 mm±1.1和0.9 mm±0.9（两种测量的p均<0.0001）。髋关节偏移的概念不能局限于股骨偏移。AO差异很大，不能忽视。在AO显著的患者中，外科医生应密切关注髋臼的准备。这应该保守进行，以便解剖放置髋臼杯以恢复天然髋关节生物力学。
