Melbourne Orthopaedic Group, Melbourne, Australia.
Monash University, Melbourne, Australia.
Bone Joint J. 2022 Jul;104-B(7):820-825. doi: 10.1302/0301-620X.104B7.BJJ-2021-1628.R1.
Adverse spinal motion or balance (spine mobility) and adverse pelvic mobility, in combination, are often referred to as adverse spinopelvic mobility (SPM). A stiff lumbar spine, large posterior standing pelvic tilt, and severe sagittal spinal deformity have been identified as risk factors for increased hip instability. Adverse SPM can create functional malposition of the acetabular components and hence is an instability risk. Adverse pelvic mobility is often, but not always, associated with abnormal spinal motion parameters. Dislocation rates for dual-mobility articulations (DMAs) have been reported to be between 0% and 1.1%. The aim of this study was to determine the early survivorship from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) of patients with adverse SPM who received a DMA.
A multicentre study was performed using data from 227 patients undergoing primary total hip arthroplasty (THA), enrolled consecutively. All the patients who had one or more adverse spine or pelvic mobility parameter had a DMA inserted at the time of their surgery. The mean age was 76 years (22 to 93) and 63% were female (n = 145). At a mean of 14 months (5 to 31) postoperatively, the AOANJRR was analyzed for follow-up information. Reasons for revision and types of revision were identified.
The AOANJRR reported two revisions: one due to infection, and the second due to femoral component loosening. No revisions for dislocation were reported. One patient died with the prosthesis in situ. Kaplan-Meier survival rate was 99.1% (95% confidence interval 98.3 to 100) at 14 months (number at risk 104).
In our cohort of patients undergoing primary THA with one or more factor associated with adverse SPM, DM bearings conferred stability at two years' follow-up. Cite this article: 2022;104-B(7):820-825.
不良的脊柱运动或平衡（脊柱活动度）以及不良的骨盆活动度，如果同时存在，通常被称为不良的脊柱骨盆活动度（SPM）。僵硬的腰椎、较大的站立时骨盆后倾和严重的矢状面脊柱畸形已被确定为髋关节不稳定的危险因素。不良的 SPM 会导致髋臼组件的功能错位，因此存在不稳定的风险。不良的骨盆活动度通常（但不总是）与异常的脊柱运动参数相关。双动关节（DMAs）的脱位率报告在 0%至 1.1%之间。本研究的目的是确定澳大利亚矫形协会全国关节置换登记处（AOANJRR）中接受 DMA 的 SPM 不良患者的早期存活率。
使用 227 名接受初次全髋关节置换术（THA）的患者的多中心研究数据进行了一项研究，这些患者连续入组。所有存在一个或多个不良脊柱或骨盆活动度参数的患者在手术时都植入了 DMA。平均年龄为 76 岁（22 至 93 岁），63%为女性（n=145）。术后平均 14 个月（5 至 31 个月），对 AOANJRR 进行随访信息分析。确定了翻修的原因和翻修的类型。
AOANJRR 报告了两次翻修：一次是由于感染，另一次是由于股骨部件松动。没有报告脱位的翻修。有一位患者在假体在位的情况下死亡。14 个月时，Kaplan-Meier 生存率为 99.1%（95%置信区间 98.3 至 100）（风险人数 104）。
在我们接受初次 THA 的患者队列中，有一个或多个与不良 SPM 相关的因素，DM 轴承在两年的随访中提供了稳定性。
