Yoshitani Junya, Kabata Tamon, Kajino Yoshitomo, Takagi Tomoharu, Ohmori Takaaki, Ueno Takuro, Ueoka Ken, Tsuchiya Hiroyuki
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa Prefecture, 920-8641, Japan.
Eur J Orthop Surg Traumatol. 2018 Dec;28(8):1625-1632. doi: 10.1007/s00590-018-2227-6. Epub 2018 Jun 27.
The influence of stem sagittal alignment on clinical outcomes is unclear in total hip arthroplasty (THA). The purpose of this study is to assess the relationship between stem sagittal alignment and clinical and radiographic outcomes using 3D-CT.
We performed 370 consecutive primary THAs between 2009 and 2013. After exclusion, 102 hips in 89 patients using single tapered-wedge stem were included. Mean follow-up was 4.7 years. Stem sagittal alignment was measured using CT, and patients were divided into flexion and neutral alignment groups. Clinical and radiographic outcomes were compared between two groups. Furthermore, we evaluated the anterior femoral offset and initial contact state.
There were no significant differences in clinical or radiographic outcomes between two groups. CT data analysis and multiple regression analysis showed flexion alignment increased anterior femoral offset (AFO) and Gruen zone 4 contact area.
There was no significant difference in clinical or radiographic outcomes between flexion and neutral alignment of the tapered-wedge stem at an average of 4.7 years of follow-up. The increase of AFO and distal contact area in flexion alignment could affect the improvement of impingement-free range of flexion and intraoperative fracture.
在全髋关节置换术（THA）中，股骨柄矢状位对线对临床疗效的影响尚不清楚。本研究的目的是使用三维CT评估股骨柄矢状位对线与临床及影像学结果之间的关系。
我们在2009年至2013年间连续进行了370例初次全髋关节置换术。排除后，纳入了89例使用单锥形楔形柄的患者的102髋。平均随访时间为4.7年。使用CT测量股骨柄矢状位对线，并将患者分为前屈和中立对线组。比较两组的临床和影像学结果。此外，我们评估了股骨前偏心距和初始接触状态。
两组之间的临床或影像学结果无显著差异。CT数据分析和多元回归分析显示，前屈对线增加了股骨前偏心距（AFO）和Gruen 4区接触面积。
在平均4.7年的随访中，锥形楔形柄的前屈和中立对线在临床或影像学结果上无显著差异。前屈对线中AFO和远端接触面积的增加可能会影响无撞击屈曲范围的改善和术中骨折情况。
