Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
Ir J Med Sci. 2013 Jun;182(2):201-5. doi: 10.1007/s11845-012-0857-y. Epub 2012 Oct 26.
Recent reports show increased failure rates in hip resurfacings that display >10 % neck narrowing. The etiology of neck narrowing remains unknown.
We assessed 80 hip resurfacings at mean 3.5 years follow-up.
The overall rate of significant narrowing was 11.25 %. Neck narrowing occurred in 4 % of patients using an anterolateral approach and 23.3 % using a posterior approach (P = 0.019). Logistic regression showed that both surgical approach and cup inclination angle were the most important risk factors for the development of narrowing. The odds of the presence of narrowing increased for every degree increase in cup abduction angle (P = 0.021). There was no significant association with age, sex, pre-operative diagnosis, pre- and post-operative SF-36 scores, neck shaft angle, femoral or acetabular component sizes.
We postulate that neck narrowing is a result of damage to the medial circumflex femoral vessel when resurfacing through a posterior approach.
最近的报告显示，颈部长径缩小超过 10%的髋关节表面置换术失败率有所增加。颈部长径缩小的病因尚不清楚。
我们对 80 例髋关节表面置换术患者进行了平均 3.5 年的随访。
总的显著狭窄发生率为 11.25%。前外侧入路组有 4%的患者出现颈部长径缩小，而后外侧入路组有 23.3%的患者出现颈部长径缩小（P = 0.019）。Logistic 回归分析显示，手术入路和髋臼杯外展角是颈部长径缩小的最重要的危险因素。髋臼杯外展角度每增加 1 度，出现狭窄的可能性就会增加（P = 0.021）。狭窄的发生与年龄、性别、术前诊断、术前和术后 SF-36 评分、颈干角、股骨或髋臼组件大小无关。
我们推测，后路髋关节表面置换术时，股内侧旋骼动脉损伤导致颈部长径缩小。
