Louette Stefan, Wignall Alice, Pandit Hemant
Trauma and Orthopaedics, Leeds Teaching Hospital Trust, Leeds, UK.
Arthroplast Today. 2022 Aug 19;17:87-93. doi: 10.1016/j.artd.2022.07.001. eCollection 2022 Oct.
The dynamic, complex interaction among the spine, pelvis, and hip is often underappreciated, yet understanding it is vital for both arthroplasty and spinal surgeons. There is an increasing incidence of degenerative hip and spinal pathologies as a result of the ageing population. Furthermore, hip pathology can cause spine pathology and vice versa through "hip-spine" and "spine-hip syndrome." Consequently, total hip arthroplasty (THA) and spinal fusion surgery, which both affect spinopelvic mobility, are also on the rise. Alteration in spinopelvic motion can affect the orientation of the acetabulum and, therefore, implant positioning in THA, leading to complications such as dislocation, impingement, aseptic loosening, and wear of components. This makes it imperative to assess spinopelvic motion and pelvic tilt prior to patients undergoing THA. In this paper, we explore how the surgeon should proceed to reduce risk of component malalignment, as well as the role of navigation systems in acetabular cup positioning.
脊柱、骨盆和髋关节之间动态、复杂的相互作用常常未得到充分重视，但对于关节置换外科医生和脊柱外科医生而言，了解这一相互作用至关重要。由于人口老龄化，退行性髋关节和脊柱疾病的发病率不断上升。此外，髋关节病变可通过“髋-脊柱”和“脊柱-髋综合征”导致脊柱病变，反之亦然。因此，全髋关节置换术（THA）和脊柱融合手术，这两种都会影响脊柱骨盆活动度的手术，也在增加。脊柱骨盆运动的改变会影响髋臼的方向，进而影响THA中植入物的定位，导致诸如脱位、撞击、无菌性松动和部件磨损等并发症。这使得在患者接受THA之前评估脊柱骨盆运动和骨盆倾斜变得势在必行。在本文中，我们探讨了外科医生应如何采取措施降低部件排列不齐的风险，以及导航系统在髋臼杯定位中的作用。
