Burapachaisri Aonnicha, Elbuluk Ameer, Abotsi Edem, Pierrepont Jim, Jerabek Seth A, Buckland Aaron J, Vigdorchik Jonathan M
Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.
Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA.
Arthroplast Today. 2020 Nov 26;6(4):945-953. doi: 10.1016/j.artd.2020.09.011. eCollection 2020 Dec.
Optimal acetabular component orientation in total hip arthroplasty (THA) is a necessity in achieving a stable implant. Although there has been considerable debate in the literature concerning the safe zone, to date, there has not been any review to determine if these references are consistent with the definition applied by Lewinnek et al. in 1978. Therefore, this article aims to examine the available literature in the PubMed database to determine how often a correct reference to the safe zone as defined by Lewinnek was applied to discussions regarding THA.
A search for literature in the PubMed database was performed for articles from 1978 to 2019. Search criteria included terms 'Lewinnek,' 'safe zone,' and 'total hip arthroplasty.' Exclusions included abstract-only articles, non-English articles, articles unrelated to THA, and those lacking full content.
A review of literature yielded 147 articles for inclusion. Overall, only 11% (17) cited the Lewinnek article correctly. Forty-five percent (66) of articles referenced measurements in the supine position, 18% (26) referenced other positions, and 37% (55) did not specify. Nineteen percent (28) reported measurements of the acetabular cup orthogonal to the anterior pelvic plane, while 73% (108) did not, and 7% (11) did not specify. Twenty-three percent (34) measured from computed tomography scans instead of other methods.
In the discussion of the safe zone regarding THA, only 11% of articles listed are consistent with the definition established by Lewinnek. This warrants further investigation into a consistent application of the term and its implications for THA implant stability and dislocation rates.
在全髋关节置换术（THA）中，髋臼组件的最佳定向是实现植入物稳定的必要条件。尽管文献中对安全区存在大量争论，但迄今为止，尚未有任何综述来确定这些参考文献是否与1978年Lewinnek等人所应用的定义一致。因此，本文旨在研究PubMed数据库中的现有文献，以确定在关于THA的讨论中，正确引用Lewinnek所定义的安全区的频率。
在PubMed数据库中搜索1978年至2019年的文献。搜索标准包括“Lewinnek”、“安全区”和“全髋关节置换术”等术语。排除仅含摘要的文章、非英文文章、与THA无关的文章以及缺乏完整内容的文章。
文献综述产生了147篇纳入文章。总体而言，只有11%（17篇）正确引用了Lewinnek的文章。45%（66篇）的文章引用了仰卧位测量值，18%（26篇）引用了其他体位测量值，37%（55篇）未明确说明。19%（28篇）报告了髋臼杯与骨盆前平面垂直的测量值，而73%（108篇）未报告，7%（11篇）未明确说明。23%（34篇）通过计算机断层扫描测量而非其他方法。
在关于THA安全区的讨论中，所列文章中只有11%与Lewinnek确立的定义一致。这值得进一步研究该术语的一致应用及其对THA植入物稳定性和脱位率的影响。
