Snijders Thom E, van Erp Joost H J, de Gast Arthur
Clinical Orthopedic Research Center - mN, Diakonessenhuis Zeist, Zeist, the Netherlands.
Department of Orthopaedic Surgery, Diakonessenhuis, Utrecht, the Netherlands.
J Orthop. 2019 May 2;16(5):396-399. doi: 10.1016/j.jor.2019.04.013. eCollection 2019 Sep-Oct.
Total hip arthroplasty (THA) is a very successful procedure in orthopedics. Still polyethylene wear and gait deficits are limiting the clinical success.It is important to reconstruct leg length (LL) and femoral offset (FO) anatomically in order to have the best possible result of a THA. Gait deficits can arise due to leg length discrepancy as well as changes in the abductor moment arm. In THA, LL and FO are strongly determined by the orientation, size and geometry of the femoral stem.
This radio-anatomical study used the data of a prospective cases series of 112 patients who underwent 126 primary THAs and had completed a 1-year follow-up examination. FO and LL were compared between the conventional straight stem in vivo and a computed simulated implantation of a short curved stem, using the pre- and postoperative pelvic radiographs of the same patients.
In this simulation of the short curved stem statistically significantly restored native FO (p = 0.010) and LL (p = 0.000) better, compared to the conventional straight stem.
Thus, the short curved stem restores FO and LL better, and could potentially prevent gait deficits.
全髋关节置换术(THA)在骨科领域是一种非常成功的手术。然而,聚乙烯磨损和步态缺陷限制了其临床效果。为了使THA获得尽可能好的结果,在解剖学上重建腿长(LL)和股骨偏心距(FO)非常重要。步态缺陷可能由于腿长差异以及外展肌力矩臂的变化而出现。在THA中,LL和FO很大程度上由股骨柄的方向、尺寸和几何形状决定。
这项放射解剖学研究使用了112例接受126次初次THA并完成1年随访检查的前瞻性病例系列数据。利用同一患者术前和术后的骨盆X线片,比较了传统直柄股骨柄在体内的情况与短弯柄股骨柄的计算机模拟植入情况之间的FO和LL。
在这项短弯柄的模拟研究中,与传统直柄相比,短弯柄在统计学上能更好地恢复天然FO(p = 0.010)和LL(p = 0.000)。
因此,短弯柄能更好地恢复FO和LL,并有可能预防步态缺陷。