Pryce Gregory M, Sabu Bismaya, Al-Hajjar Mazen, Wilcox Ruth K, Thompson Jonathan, Isaac Graham H, Board Tim, Williams Sophie
Institute of Medical and Biological Engineering, University of Leeds, Leeds, UK.
DePuy Synthes Joint Reconstruction, Leeds, UK.
Proc Inst Mech Eng H. 2022 Feb 11;236(4):9544119211069472. doi: 10.1177/09544119211069472.
Total Hip Arthroplasty (THA) is one of the most common and successful surgical interventions. The survivorship at 10 years for the most commonly used systems is over 95%. However, the incidence of revision is usually much higher in the 0-1 year time period following the intervention. The most common reason for revision in this early time period is dislocation and subluxation, which may be defined as complete or permanent, and partial or temporary loss of contact between the bearing surfaces respectively. This study comprises the development of a geometric model of bone and an in situ total hip replacement, to predict the occurrence and location of bone and component impingement for a wide range of acetabular cup positions and for a series of frequently practiced activities of daily living. The model developed predicts that anterior-superior component impingement is associated with activities that result in posterior dislocation. The incidence may be reduced by increased cup anteversion and inclination. Posterior-inferior component impingement is associated with anterior dislocation activities. Its incidence may be reduced by decreased cup anteversion and inclination. A component impingement-free range was identified, running from when the cup was positioned with 45° inclination and 25° anteversion to 70° inclination and 15°-20° anteversion.
全髋关节置换术（THA）是最常见且成功的外科手术干预措施之一。最常用系统的10年生存率超过95%。然而，在干预后的0至1年时间段内，翻修率通常要高得多。在此早期时间段内翻修的最常见原因是脱位和半脱位，分别可定义为承重面之间完全或永久性以及部分或暂时性失去接触。本研究包括建立骨骼几何模型和原位全髋关节置换模型，以预测在广泛的髋臼杯位置以及一系列日常常见活动中骨骼和假体撞击的发生情况及位置。所建立的模型预测，前上假体撞击与导致后脱位的活动相关。通过增加髋臼杯前倾角和倾斜度，其发生率可能会降低。后下假体撞击与前脱位活动相关。通过减小髋臼杯前倾角和倾斜度，其发生率可能会降低。确定了一个无假体撞击范围，即从髋臼杯倾斜45°、前倾角25°到倾斜70°、前倾角15° - 20°的位置。
