Carender Christopher N, Meyer Matthew D, Wynn Malynda S, Bedard Nicholas A, Otero Jesse E, Brown Timothy S
Department of Orthopedics & Rehabilitation, University of Iowa Hospital & Clinics, Iowa City, IA, USA.
University of Iowa, Carver College of Medicine, Iowa City, IA, USA.
Arthroplast Today. 2020 Jun 16;6(3):381-385. doi: 10.1016/j.artd.2020.05.010. eCollection 2020 Sep.
The prevalence of an abnormal spinopelvic relationship in patients presenting for primary total hip arthroplasty (THA) is not well known. The purpose of this study was to identify the prevalence of abnormal spinopelvic relationships in patients presenting for primary THA.
A retrospective chart review of 338 consecutive, nonselected patients undergoing primary THA from the practice of 2 fellowship-trained adult reconstruction surgeons was performed (J.E.O. and T.S.B.). Sitting and standing radiographs were measured for lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt; the sacral slope was also measured on sitting radiographs (SS). Patients were assessed for the presence of spinopelvic imbalance, defined as PI-LL>10°, and decreased spinopelvic motion, defined as SS-SS< 10°. Descriptive statistics were reported.
A cohort of 338 patients was identified; 110 were excluded. In total, 228 unique patients underwent measurement. One hundred one of 228 patients (44.3%) in the cohort were female. The mean age of the cohort was 60.0 ± 13 years, with the mean body mass index of 31 ± 7 mg/kg. Spinopelvic imbalance (PI-LL > 10°) was present in 142 of 228 patients (62.3%). Decreased motion at the spinopelvic junction (SS-SS < 10°) was present in 78 of 228 patients (34.2%). Fifty (21.9%) patients had both spinopelvic imbalance and decreased spinopelvic motion.
In a cohort of 228 patients presenting for primary THA, the prevalence of spinopelvic imbalance was 62.3%, the prevalence of decreased spinopelvic motion was 34.2%, and the prevalence of both spinopelvic imbalance and decreased spinopelvic motion was 22%. Hip surgeons are likely to encounter patients with abnormal spinopelvic relationships.
初次全髋关节置换术（THA）患者中异常脊柱骨盆关系的发生率尚不清楚。本研究的目的是确定初次行THA患者中异常脊柱骨盆关系的发生率。
对两位接受过成人重建外科 fellowship 培训的医生（J.E.O. 和 T.S.B.）所诊治的 338 例连续、未经筛选的初次行 THA 的患者进行回顾性病历审查。测量坐位和站立位 X 线片上的腰椎前凸（LL）、骨盆入射角（PI）、骶骨倾斜度（SS）和骨盆倾斜度；骶骨倾斜度也在坐位 X 线片上测量（SS）。评估患者是否存在脊柱骨盆失衡（定义为 PI-LL>10°）以及脊柱骨盆运动减少（定义为 SS-SS<10°）。报告描述性统计数据。
确定了 338 例患者队列；排除 110 例。总共 228 例患者接受了测量。队列中的 228 例患者中有 101 例（44.3%）为女性。队列的平均年龄为 60.0±13 岁，平均体重指数为 31±7mg/kg。228 例患者中有 142 例（62.3%）存在脊柱骨盆失衡（PI-LL>10°）。228 例患者中有 78 例（34.2%）存在脊柱骨盆交界处运动减少（SS-SS<10°）。50 例（21.9%）患者同时存在脊柱骨盆失衡和脊柱骨盆运动减少。
在 228 例初次行 THA 的患者队列中，脊柱骨盆失衡的发生率为 62.3%，脊柱骨盆运动减少的发生率为 34.2%，同时存在脊柱骨盆失衡和脊柱骨盆运动减少的发生率为 22%。髋关节外科医生很可能会遇到脊柱骨盆关系异常的患者。
