Department of Orthopaedic Surgery, Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
J Arthroplasty. 2013 Sep;28(8 Suppl):41-4. doi: 10.1016/j.arth.2013.05.035. Epub 2013 Jul 30.
Acetabular cup positioning is a critical factor in determining adverse clinical outcomes in THA. This evaluation was performed to determine if morbid obesity (BMI ≥35kg/m(2)) is a contributing risk factor to cup malpositioning. Two groups of patients were obtained from a local arthroplasty registry and match-controlled for gender, age, and diagnosis (n=211 morbidly obese; n=211 normal). Intraoperative data and postoperative AP pelvis and cross-table lateral radiographs were obtained for each patient. The Martell Hip Analysis Suite was used to calculate cup positioning (successful positioning defined as 30°-45° of abduction, and 5°-25° of anteversion), as well as varus-valgus alignment of the femoral stem. There was a significant correlation between morbid obesity with respect to underanteversion; using multivariate analysis, there was a trend toward a combined underanteversion/overabduction of the acetabular cup. Of all variables considered, high BMI was the most significant risk factor leading to malpositioning.
髋臼杯定位是全髋关节置换术（THA）中决定不良临床结果的关键因素。本研究旨在评估病态肥胖（BMI≥35kg/m²）是否是导致髋臼杯位置不良的危险因素。从当地关节置换登记处获得了两组患者，并按性别、年龄和诊断进行了匹配对照（病态肥胖组 n=211；正常组 n=211）。对每位患者均获取了术中数据和术后骨盆正位片及交叉位侧位片。使用 Martell Hip Analysis Suite 计算髋臼杯的定位（成功定位定义为外展 30°-45°，前倾角 5°-25°），以及股骨柄的内翻-外翻对线。病态肥胖与髋臼杯前倾角不足显著相关；采用多变量分析，髋臼杯存在前倾角不足/外展过度的趋势。在考虑的所有变量中，高 BMI 是导致髋臼杯位置不良的最重要危险因素。
