Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan,
Int Orthop. 2014 Jan;38(1):27-32. doi: 10.1007/s00264-013-2091-2. Epub 2013 Sep 13.
The combined anteversion (CA) technique is a method in which the cup is placed according to the stem anteversion in total hip arthroplasty (THA). We examined whether the CA technique reduced the dislocation rate, and the distribution of CA with the manual placement of the cup.
We retrospectively reviewed 634 hips in 579 patients with primary cementless THA. In 230 hips using the CA technique [CA(+)], a CA of 50 ± 10° was the aim. In the remaining 404 hips [CA(-)], the cup was first placed targeting 20° of anteversion. The post-operative CA was measured using the computed tomography (CT) images in 111 hips.
One hip (0.4%) had a dislocation in the CA(+) group, whereas ten hips (2.5%) had a dislocation in the CA(-) group. A multivariate analysis showed that primary diagnosis, head size and CA technique significantly influenced the dislocation rate. Patients in the CA(-) group were 5.8 times more likely to have a dislocation compared to the CA(+) group. In the 111 hips with CT images, 81 hips (73.0%) achieved the intended CA.
Although the manual placement of the cup resulted in 27% of outliers from the intended CA, the CA technique significantly reduced the dislocation after primary THA.
在全髋关节置换术（THA）中，组合前倾角（CA）技术是一种根据柄的前倾角放置髋臼杯的方法。我们研究了 CA 技术是否降低了脱位率，以及在手动放置髋臼杯时 CA 的分布情况。
我们回顾性分析了 579 例初次行非骨水泥 THA 的 634 髋。在 230 髋采用 CA 技术[CA（+）]中，目标 CA 为 50±10°。在其余 404 髋[CA（-）]中，首先以 20°前倾角放置髋臼杯。术后通过 CT 图像测量 CA。
在 CA（+）组中，1 髋（0.4%）发生脱位，而在 CA（-）组中，10 髋（2.5%）发生脱位。多变量分析显示，主要诊断、股骨头尺寸和 CA 技术显著影响脱位率。与 CA（+）组相比，CA（-）组患者发生脱位的风险高 5.8 倍。在有 CT 图像的 111 髋中，81 髋（73.0%）达到了预期的 CA。
尽管手动放置髋臼杯导致 27%的 CA 偏离目标值，但 CA 技术显著降低了初次 THA 后的脱位率。
