Tateda Kenji, Nagoya Satoshi, Suzuki Daisuke, Kosukegawa Ima, Yamashita Toshihiko
Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Hip Pelvis. 2021 Mar;33(1):25-32. doi: 10.5371/hp.2021.33.1.25. Epub 2021 Mar 2.
The current study aimed to investigate the morphology of the true acetabulum in developmental dysplasia of the hip (DDH) with high dislocation. A secondary was to evaluate the acetabular cup placement in patients with high dislocation who were treated with total hip arthroplasty (THA).
Using a retrospective design, 23 hips with DDH with high dislocation in patients who were treated with THA were included in this study. We measured the depth, width and thickness of the anterior and posterior walls of the original acetabulum using preoperative computed tomography images and investigated the cup size applied in these cases.
The mean depth and width of the acetabulum was 18.4 and 16.2 mm proximal end, 18.4 and 24.3 mm in the middle, and 15.8 and 27.6 mm at the distal part. Mean thickness of the anterior and posterior walls was 10.9 and 23.9 mm at the proximal end, 10.3 and 22.2 mm in the middle, and 10.9 and 22.7 mm at the distal part. A 42-mm cup was using in one hip, a 46-mm cup in three hips, a 48-mm cup in 13 hips, and a 50-mm cup in six hips.
In patients with Crowe IV DDH, the morphology of the acetabulum comprises a triangle that broadens from proximal to distal points, with a relatively thick posterior wall. Reaming the acetabulum posteriorly and inferiorly may enable the placement of a relatively larger cup to achieve stable fixation.
本研究旨在调查高位脱位的发育性髋关节发育不良（DDH）中真髋臼的形态。其次是评估接受全髋关节置换术（THA）治疗的高位脱位患者的髋臼杯放置情况。
采用回顾性设计，本研究纳入了23例接受THA治疗的高位脱位DDH患者的髋关节。我们使用术前计算机断层扫描图像测量了原始髋臼前后壁的深度、宽度和厚度，并调查了这些病例中应用的髋臼杯尺寸。
髋臼近端的平均深度和宽度分别为18.4和16.2mm，中部为18.4和24.3mm，远端为15.8和27.6mm。前后壁近端的平均厚度分别为10.9和23.9mm，中部为10.3和22.2mm，远端为10.9和22.7mm。1例髋关节使用42mm的髋臼杯，3例使用46mm的髋臼杯，13例使用48mm的髋臼杯，6例使用50mm的髋臼杯。
在Crowe IV型DDH患者中，髋臼形态为从近端到远端逐渐变宽的三角形，后壁相对较厚。向后下方扩髋臼可能有助于放置相对较大的髋臼杯以实现稳定固定。
