Ishii Seiya, Homma Yasuhiro, Baba Tomonori, Jinnai Yuta, Zhuang Xu, Tanabe Hiroki, Banno Sammy, Matsumoto Mikio, Watari Taiji, Ozaki Yu, Ochi Hironori, Kaneko Kazuo
Department of Orthopaedic Surgery, Juntendo University, 1-1-2, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Arthroplasty. 2021 Jan 31;3(1):2. doi: 10.1186/s42836-020-00060-6.
Total hip arthroplasty (THA) via the direct anterior approach (DAA) using dual mobility cup (DMC) is considered to effectively prevent postoperative dislocation. However, the dislocation and reduction procedure using a trial implant during the surgery is difficult because of high soft tissue tension. Thereby, leg length discrepancy (LLD) is difficult to assess when using DM via the DAA.
To compare the LLD between cases using conventional SM and those using DMC in THA via the DAA with fluoroscopy.
We retrospectively investigated 34 hips treated with DMC (DMC-DAA group) and 31 hips treated with SM (SM-DAA group). The LLD was defined as the difference in the distance from the teardrop to the medial-most point of the lesser trochanter between the operative and nonoperative sides at immediate postoperative X-ray.
The mean LLD in the DMC-DAA group and SM-DAA group was 0.68 ± 7.7 mm and 0.80 ± 5.5, respectively, with no significant difference. The absolute value of the LLD in the DMC-DAA group and SM-DAA group was 6.3 ± 4.4 mm and 5.9 ± 5.5, respectively, with no significant difference.
Despite the difficulty in assessment of the LLD during THA via the DAA using DMC, this technique does not increase the LLD compared with the use of SM.
III, matched case-control study.
采用双动髋臼杯（DMC）经直接前方入路（DAA）进行全髋关节置换术（THA）被认为可有效预防术后脱位。然而，由于软组织张力高，术中使用试验植入物时的脱位和复位操作困难。因此，经DAA使用DMC时，下肢长度差异（LLD）难以评估。
通过透视比较经DAA行THA时使用传统单动髋臼杯（SM）和使用DMC的病例之间的LLD。
我们回顾性研究了34例使用DMC治疗的髋关节（DMC-DAA组）和31例使用SM治疗的髋关节（SM-DAA组）。LLD定义为术后即刻X线片上手术侧与非手术侧泪滴至小转子最内侧点距离的差值。
DMC-DAA组和SM-DAA组的平均LLD分别为0.68±7.7mm和0.80±5.5mm，无显著差异。DMC-DAA组和SM-DAA组LLD的绝对值分别为6.3±4.4mm和5.9±5.5mm，无显著差异。
尽管经DAA使用DMC进行THA时评估LLD存在困难，但与使用SM相比，该技术不会增加LLD。
III，配对病例对照研究。
