髋臼发育不良及除直接前路以外的手术入路会增加全髋关节置换术中髋臼假体位置不当的风险。
Acetabular Dysplasia and Surgical Approaches Other Than Direct Anterior Increases Risk for Malpositioning of the Acetabular Component in Total Hip Arthroplasty.
作者信息
Gromov Kirill, Greene Meridith E, Huddleston James I, Emerson Roger, Gebuhr Peter, Malchau Henrik, Troelsen Anders
机构信息
Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts; Department of Orthopaedic Surgery, Copenhagen Hospital, Hvidovre, Copenhagen, Denmark.
Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
出版信息
J Arthroplasty. 2016 Apr;31(4):835-41. doi: 10.1016/j.arth.2015.10.045. Epub 2015 Nov 10.
BACKGROUND
Persistent acetabular dysplasia (AD) after periacetabular osteotomy has been hypothesized to increase the risk for malpositioning of the acetabular component. In this study, we investigate whether AD is an independent risk factor for cup malpositioning during primary total hip arthroplasty (THA).
METHODS
Patient demographics, surgical approach, presence of AD assessed using the lateral center-edge angle, and acetabular cup positioning determined using Martell Hip Analysis Suite were investigated in 836 primary THA patients enrolled in a prospective multicenter study.
RESULTS
We found that presence of AD, defined as the lateral center-edge angle of <25°, is an independent risk factor for malpositioning of the acetabular component during primary THA. Surgical approach other than direct anterior was also independently associated with malpositioned cups.
CONCLUSIONS
Surgeons should therefore take special care during placement of the acetabular component in patients with AD.
背景
髋臼周围截骨术后持续存在髋臼发育不良（AD）被认为会增加髋臼假体位置不当的风险。在本研究中，我们调查AD是否是初次全髋关节置换术（THA）期间髋臼假体位置不当的独立危险因素。
方法
在一项前瞻性多中心研究纳入的836例初次THA患者中，调查了患者人口统计学、手术入路、使用外侧中心边缘角评估的AD情况以及使用Martell髋关节分析套件确定的髋臼杯位置。
结果
我们发现，定义为外侧中心边缘角<25°的AD是初次THA期间髋臼假体位置不当的独立危险因素。除直接前路以外的手术入路也与髋臼杯位置不当独立相关。
结论
因此，外科医生在为AD患者放置髋臼假体时应格外小心。
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