Boese Christoph K, Dargel Jens, Jostmeier Janine, Eysel Peer, Frink Michael, Lechler Philipp
Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, Germany.
Center of Orthopedic and Trauma Surgery, University of Giessen and Marburg, Marburg, Germany.
J Arthroplasty. 2016 Aug;31(8):1842-8. doi: 10.1016/j.arth.2016.02.015. Epub 2016 Feb 17.
The present study aimed to analyze the agreement between proximal femoral geometry of adult hips and femoral component design in total hip arthroplasty.
Anatomical femoral offset (FOAnat) and the anatomical neck-shaft angle (NSAAnat) of 800 adult hips were measured by computed tomography scans, and anatomical femoral neck height (FHAnat) was calculated. Corresponding best-fit implants of the most common hip system (standard, high offset and varus variant) were identified for each hip. Finally, the precision of the best possible anatomic reconstruction was assessed.
The mean FOAnat was 38.0 mm (range: 19.8-57.9 mm, standard deviation [SD]: 6.4 mm), the mean NSAAnat was 130.8° (range: 107.1°-151.9°; SD: 6.5°), and the mean FHAnat was 32.6 mm (range: 14.4-52.0 mm; SD: 5.5 mm). In 450 (56.3%) hips, the standard variant was identified to be the best-fit implant, followed by the varus (n = 282, 35.3%) and the high offset (n = 68, 8.5%) variants. The mean minimal distance from the best-fit implant was 4.5 mm (range: 0.1-20.2 mm, SD: 3.4 mm). Excellent agreement (distance: <2 mm) between hip anatomy and best-fit implant was found in 203 (25.4%) hips, combined excellent and acceptable agreement (distance: <6 mm) in 569 (71.1%) hips, whereas 213 (28.9%) hips were graded as poor (distance: ≥6 mm).
The present study revealed a mismatch between proximal femoral anatomy of a relevant proportion of adult hips and implant geometry of the most common femoral component in total hip arthroplasty.
本研究旨在分析成人髋关节股骨近端几何形状与全髋关节置换术中股骨假体设计之间的一致性。
通过计算机断层扫描测量800例成人髋关节的解剖学股骨偏心距（FOAnat）和解剖学颈干角（NSAAnat），并计算解剖学股骨颈高度（FHAnat）。为每个髋关节确定最常见髋关节系统（标准型、高偏心距型和内翻型）的相应最佳匹配假体。最后，评估最佳解剖重建的精度。
平均FOAnat为38.0mm（范围：19.8 - 57.9mm，标准差[SD]：6.4mm），平均NSAAnat为130.8°（范围：107.1° - 151.9°；SD：6.5°），平均FHAnat为32.6mm（范围：14.4 - 52.0mm；SD：5.5mm）。在450例（56.3%）髋关节中，标准型假体被确定为最佳匹配假体，其次是内翻型（n = 282，35.3%）和高偏心距型（n = 68，8.5%）假体。最佳匹配假体的平均最小距离为4.5mm（范围：0.1 - 20.2mm，SD：3.4mm）。203例（25.4%）髋关节的髋关节解剖结构与最佳匹配假体之间存在极佳的一致性（距离：<2mm），569例（71.1%）髋关节的一致性为极佳和可接受（距离：<6mm），而213例（28.9%）髋关节的一致性较差（距离：≥mm）。
本研究揭示了相当比例的成人髋关节股骨近端解剖结构与全髋关节置换术中最常见股骨假体的几何形状不匹配。
