Goodman Gens P, Goyal Nitin, Parks Nancy L, Hopper Robert H, Hamilton William G
Anderson Orthopaedic Research Institute, Alexandria, Virginia - USA.
Hip Int. 2017 Nov 21;27(6):573-577. doi: 10.5301/hipint.5000507. Epub 2017 Jul 19.
The purpose of this study was to compare acetabular cup position for 2 cohorts of total hip arthroplasty (THA) patients who had a direct anterior approach.
100 THA cases were performed with an anterior approach using intraoperative fluoroscopy (IF) to aid in cup positioning. Another group of 100 cases underwent THA with an anterior approach without the use of any fluoroscopy. Postoperative abduction and anteversion angles were measured using Martell's hip analysis software.
Mean abduction angle was 43.2° (standard deviation (SD) = 4.5°) for the IF group versus 37.5°(SD = 7.4°) for cases without IF (p<0.001). 18% more cases with IF fell within the Lewinnek safe zone (p<0.001); however, a similar number of cases had over 50° of abduction. The mean anteversion angles of the two groups were also significantly different (IF 21.8° vs. 24.9°) (p<0.01).
There was significantly less variation in cup position among the cases using IF with regards to abduction.
本研究的目的是比较两组采用直接前路全髋关节置换术（THA）患者的髋臼杯位置。
100例THA病例采用前路手术，术中使用透视（IF）辅助髋臼杯定位。另一组100例病例采用前路THA手术，不使用任何透视。使用马特尔髋关节分析软件测量术后外展和前倾角。
IF组的平均外展角为43.2°（标准差（SD）=4.5°），而未使用IF的病例为37.5°（SD = 7.4°）（p<0.001）。使用IF的病例中有18%更多的病例落在Lewinnek安全区内（p<0.001）；然而，有相似数量的病例外展超过50°。两组的平均前倾角也有显著差异（IF组为21.8°，另一组为24.9°）（p<0.01）。
在使用IF的病例中，髋臼杯位置在外展方面的变异显著更小。
