Department of Joint Surgery, Zhengzhou Orthopaedic Hospital, 58 Longhai Middle Road, Zhengzhou City, Henan Province, China.
J Orthop Surg Res. 2019 Aug 28;14(1):279. doi: 10.1186/s13018-019-1331-6.
In this study, we described a positioner which allows a combination of preoperative plan and intraoperative insertion of the cup to improve the reconstruction of the rotation center of the hip.
A retrospective study was conducted on 32 consecutive patients (group A) using this positioner and 40 consecutive patients (group B) using conventional method; radiological parameters and clinical measurements before operation and at last follow-up were collected and evaluated.
Group A had a reconstructed center of rotation (COR) that was 0.19 mm closer to the anatomic COR in height (P < 0.005), compared with group B with 3.45 mm vertical dislocation. There were no statistically significant differences in the horizontal displacement between the two groups. The accuracy of cup inclination was 42.14 ± 3.57 in the group A and 38.73 ± 7.65 in the group B (P = 0.015). The accuracy of cup anteversion was 14.82 ± 1.44 in the group A and 13.08 ± 5.95 in the group B (P = 0.082). All cups in the group A were radiologically stable, while one cup in the group B was radiologically unstable and was successfully treated with second-stage revision. Both of the groups obtained a higher mean postoperative Harris Hip Score.
Utilizing this positioner helps to restore the COR position more precisely and provides satisfactory radiological and clinical outcomes in the short term, and more studies are required before its widespread adoption for complicated cases.
本研究描述了一种定位器,可将术前计划和术中杯插入相结合,以改善髋关节旋转中心的重建。
回顾性分析使用该定位器的 32 例连续患者(A 组)和使用常规方法的 40 例连续患者(B 组)。收集并评估术前和末次随访时的影像学参数和临床测量值。
A 组重建的旋转中心(COR)在高度上比 B 组更接近解剖 COR,相差 0.19mm(P<0.005),B 组有 3.45mm 的垂直错位。两组间水平位移无统计学差异。A 组杯倾斜角度的准确性为 42.14±3.57,B 组为 38.73±7.65(P=0.015)。A 组杯前倾角的准确性为 14.82±1.44,B 组为 13.08±5.95(P=0.082)。A 组所有杯均影像学稳定,而 B 组有 1 个杯影像学不稳定,二期翻修后成功治疗。两组术后 Harris 髋关节评分均较高。
使用该定位器有助于更精确地恢复 COR 位置,并提供短期满意的影像学和临床结果,但在广泛应用于复杂病例之前,还需要更多的研究。