髋臼横韧带作为术中髋臼杯外展的导向
The Transverse Acetabular Ligament as an Intraoperative Guide to Cup Abduction.
作者信息
Hiddema Willem B, van der Merwe Johan F, van der Merwe Werner
机构信息
Department of Orthopedic Surgery, University of the Free State, Universitas Academic Hospital, Bloemfontein, South Africa.
Mediclinic Bloemfontein, Bloemfontein, South Africa.
出版信息
J Arthroplasty. 2016 Jul;31(7):1609-13. doi: 10.1016/j.arth.2016.01.019. Epub 2016 Jan 21.
BACKGROUND
The success of a total hip arthroplasty relies on optimal acetabular cup placement to ensure mating of the femoral head and acetabular cup throughout all positions of the hip joint. Poor cup placement is associated with dislocation, impingement, microseparation, component loosening, and accelerated wear due to rim loading. This study examined a novel method of using the transverse acetabular ligament (TAL) to guide cup inclination during primary total hip arthroplasty.
METHODS
A descriptive study using 16 hips from 9 cadavers. A computer navigation system measured inclination and version of the acetabular component in 3 positions with the lower edge of cup: (1) flush with, (2) 5 mm proximal to, and (3) 5 mm distal to free border of the TAL.
RESULTS
The median inclination angles were 44° in position (1), 30° in position (2), and 64° in position (3). The median anteversion angle for all positions was 19°.
CONCLUSION
Cup inclination was acceptable when the lower edge of the cup was flush or within 5 mm proximal to the TAL.
背景
全髋关节置换术的成功依赖于髋臼杯的最佳放置，以确保在髋关节的所有位置上股骨头与髋臼杯相匹配。髋臼杯放置不当会导致脱位、撞击、微分离、假体松动以及由于边缘负荷导致的加速磨损。本研究探讨了一种在初次全髋关节置换术中使用髋臼横韧带（TAL）来引导髋臼杯倾斜度的新方法。
方法
一项描述性研究，使用来自9具尸体的16个髋关节。计算机导航系统测量髋臼组件在髋臼杯下缘的3个位置的倾斜度和前倾角：（1）与TAL游离缘齐平，（2）在TAL游离缘近端5毫米处，（3）在TAL游离缘远端5毫米处。
结果
位置（1）的中位倾斜角为44°，位置（2）为30°，位置（3）为64°。所有位置的中位前倾角为19°。
结论
当髋臼杯下缘与TAL齐平或在TAL近端5毫米范围内时，髋臼杯倾斜度是可接受的。
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