Department of Orthopaedics, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian, Beijing, 100853, China.
Nankai University, No.94 Weijin Road, Nankai, Tianjin, 300071, China.
BMC Musculoskelet Disord. 2020 Aug 3;21(1):516. doi: 10.1186/s12891-020-03545-2.
The impact of handedness on clinical outcomes was easily overlooked in hip replacement. This study aimed to find whether the component positioning and hip function were affected by the handedness in total hip arthroplasty (THA) through direct anterior approach (DAA).
Total 102 patients who underwent bilateral DAA-THAs simultaneously between May 2016 and November 2018 in our institute were reviewed. All surgeries were operated by one right-handed surgeon. Their demographic, cup positioning, stem alignment, femoral stem fit, Harris hip score (HHS), intraoperative and postoperative complications were used to evaluate the role of handedness in DAA.
The inclination of left cups was significantly larger than that of right cups (42.61 ± 7.32 vs 39.42 ± 7.19, p = 0.000). The stem fit of left femur was significantly larger than that of right femur (84.34 ± 4.83 vs 82.81 ± 6.07, p = 0.043). No significant differences in safe zone ratio, HHS and complications between bilateral hips were found.
A surgeon's handedness had significant impact on cup's inclination and femoral stem fit in DAA-THA. However, there were no significant differences of cup malpositioning, stem alignment, hip function scores and complications between bilateral DAA-THAs.
在髋关节置换术中，手性对临床结果的影响很容易被忽视。本研究旨在通过直接前入路（DAA）探讨在全髋关节置换术（THA）中，手性是否会影响组件定位和髋关节功能。
回顾了 2016 年 5 月至 2018 年 11 月期间在我院同期行双侧 DAA-THA 的 102 例患者。所有手术均由一位右利手医生完成。通过评估患者的人口统计学资料、杯体定位、柄的对线、股骨柄的适配、Harris 髋关节评分（HHS）、术中及术后并发症等，评估手性在 DAA 中的作用。
左侧杯体的倾斜度明显大于右侧（42.61 ± 7.32 比 39.42 ± 7.19，p = 0.000）。左侧股骨柄的适配度明显大于右侧（84.34 ± 4.83 比 82.81 ± 6.07，p = 0.043）。双侧髋关节的安全区比例、HHS 和并发症无显著差异。
术者的手性对 DAA-THA 中的杯体倾斜度和股骨柄适配度有显著影响。然而，双侧 DAA-THA 之间在杯体位置不良、柄的对线、髋关节功能评分和并发症方面没有显著差异。
