Halai M, Gupta S, Gilmour A, Bharadwaj R, Khan A, Holt G
University Hospital Crosshouse, Kilmarnock KA2 OBE, UK.
Bone Joint J. 2015 Feb;97-B(2):154-9. doi: 10.1302/0301-620X.97B2.34530.
We evaluated an operative technique, described by the Exeter Hip Unit, to assist accurate introduction of the femoral component. We assessed whether it led to a reduction in the rate of leg-length discrepancy after total hip arthroplasty (THA). A total of 100 patients undergoing THA were studied retrospectively; 50 were undertaken using the test method and 50 using conventional methods as a control group. The groups were matched with respect to patient demographics and the grade of surgeon. Three observers measured the depth of placement of the femoral component on post-operative radiographs and measured the length of the legs. There was a strong correlation between the depth of insertion of the femoral component and the templated depth in the test group (R = 0.92), suggesting accuracy of the technique. The mean leg-length discrepancy was 5.1 mm (0.6 to 21.4) pre-operatively and 1.3 mm (0.2 to 9.3) post-operatively. There was no difference between Consultants and Registrars as primary surgeons. Agreement between the templated and post-operative depth of insertion was associated with reduced post-operative leg-length discrepancy. The intra-class coefficient was R ≥ 0.88 for all measurements, indicating high observer agreement. The post-operative leg-length discrepancy was significantly lower in the test group (1.3 mm) compared with the control group (6.3 mm, p < 0.001). The Exeter technique is reproducible and leads to a lower incidence of leg-length discrepancy after THA.
我们评估了一种由埃克塞特髋关节治疗组描述的手术技术，以辅助股骨假体的准确植入。我们评估了该技术是否能降低全髋关节置换术（THA）后双下肢长度差异的发生率。对100例行THA的患者进行了回顾性研究；50例采用试验方法，50例采用传统方法作为对照组。两组在患者人口统计学和外科医生级别方面进行了匹配。三名观察者在术后X线片上测量股骨假体的植入深度，并测量双下肢长度。试验组中股骨假体的植入深度与模板深度之间存在很强的相关性（R = 0.92），表明该技术的准确性。术前双下肢平均长度差异为5.1 mm（0.6至21.4），术后为1.3 mm（0.2至9.3）。作为主刀医生，顾问医生和住院医生之间没有差异。模板植入深度与术后植入深度之间的一致性与术后双下肢长度差异的减小有关。所有测量的组内系数R≥0.88，表明观察者之间高度一致。试验组术后双下肢长度差异（1.3 mm）明显低于对照组（6.3 mm，p < 0.001）。埃克塞特技术具有可重复性，且能降低THA后双下肢长度差异的发生率。
