全髋关节置换术中螺钉固定后髋臼对线的变化
Cup Alignment Change after Screw Fixation in Total Hip Arthroplasty.
作者信息
Suksathien Yingyong, Piyapromdee Urawit, Tippimanchai Thanut
机构信息
Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Mueang, Nakhon Ratchasima Province, Thailand.
出版信息
Indian J Orthop. 2019 Sep-Oct;53(5):618-621. doi: 10.4103/ortho.IJOrtho_451_18.
BACKGROUND
Cup malalignment increase impingement, dislocation, cup migration, and polyethylene wear. Screw fixation for enhanced stability is the preferred option in cases of doubtful primary cup stability. There have been few studies about alignment changes after screw fixation, which may be another cause of cup malalignment. This study aimed to evaluate cup alignment change after screw fixation.
MATERIALS AND METHODS
Patients undergoing imageless navigation total hip arthroplasty using screws fixation for acetabular cup were corrected. After the press-fit cup was fully seated, the cup orientation was recorded. After screws were inserted, the cup orientation was recorded again to calculate the alignment change.
RESULTS
There were 99 cases with a mean age 63.7 years (25-93). Alignment change after screw fixation was found in 73 cases (73.7%). There were 56 cases (56.6%) with inclination angle change and the mean change was 2.21° (0°-8°). The inclination angle increased in 47 cases (47.5%) with 9 cases (9.1%) increased by 5° or more and decreased in 9 cases (9.1%). There was statistically significant difference between patients using one screw and patients using two or more screws in inclination angle change, 1.56° (0°-5°) and 3.4° (0°-8°), respectively ( = 0.0039). There was statistically significant correlation between inclination angle change and number of screws ( = 0.5401, < 0.01). There were 49 cases (49.5%) with anteversion angle change and the mean change was 1.67° (0°-5°). The anteversion angle increased in 31 cases (31.3%), decreased in 18 cases (18.2%) with two cases (2%) decreased by 5° or more. There was significant difference between patients using one screw and patients using two or more screws in anteversion angle change, 1.46° (0°-5°) and 2.21° (0°-5°), respectively ( = 0.009). There was significant correlation between anteversion angle change and number of screws ( = 0.284, = 0.048).
CONCLUSIONS
Changes in cup alignment after screw fixation were detected in most cases. It is one possible cause of cup malalignment.
背景
髋臼杯排列不齐会增加撞击、脱位、髋臼杯移位和聚乙烯磨损。在初次髋臼杯稳定性存疑的情况下，采用螺钉固定以增强稳定性是首选方案。关于螺钉固定后排列变化的研究较少，这可能是髋臼杯排列不齐的另一个原因。本研究旨在评估螺钉固定后髋臼杯排列的变化。
材料与方法
对接受无影像导航全髋关节置换术并使用螺钉固定髋臼杯的患者进行校正。压配式髋臼杯完全就位后，记录髋臼杯的方向。插入螺钉后，再次记录髋臼杯的方向以计算排列变化。
结果
共99例患者，平均年龄63.7岁（25 - 93岁）。73例（73.7%）患者在螺钉固定后出现排列变化。56例（56.6%）患者有倾斜角变化，平均变化为2.21°（0° - 8°）。倾斜角增加的有47例（47.5%），其中9例（9.1%）增加5°或更多，减少的有9例（9.1%）。使用一枚螺钉的患者与使用两枚或更多螺钉的患者在倾斜角变化方面存在统计学显著差异，分别为1.56°（0° - 5°）和3.4°（0° - 8°）（P = 0.0039）。倾斜角变化与螺钉数量之间存在统计学显著相关性（r = 0.5401，P < 0.01）。49例（49.5%）患者有前倾角变化，平均变化为1.67°（0° - 5°）。前倾角增加的有31例（31.3%），减少的有18例（18.2%），其中两例（2%）减少5°或更多。使用一枚螺钉的患者与使用两枚或更多螺钉的患者在前倾角变化方面存在显著差异，分别为1.46°（0° - 5°）和2.21°（0° - 5°）（P = 0.009）。前倾角变化与螺钉数量之间存在显著相关性（r = 0.284，P = 0.048）。
结论
大多数病例中检测到螺钉固定后髋臼杯排列发生变化。这是髋臼杯排列不齐的一个可能原因。
Zotero 插件