Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
Department of Anatomy and Cell Biology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Sci Rep. 2023 Mar 1;13(1):3492. doi: 10.1038/s41598-023-30734-5.
Iliopsoas impingement after total hip arthroplasty is caused by the implant irritating the iliopsoas muscle, but changes in the iliopsoas muscle have not been quantitatively evaluated. This study assessed changes in the surface pressure of the iliopsoas muscle when the implant alignment was varied. Total hip arthroplasty was performed in 10 fresh-frozen cadaveric hips. We evaluated the maximum and mean surface pressure of the iliopsoas muscle with the hip in 20° and 10° extension, the neutral position, and 10° flexion when the anterior cup protrusion length (ACPL), stem version, and stem offset were varied. When the ACPL was changed to 0, 3, and 6 mm in 20° extension, the maximum surface pressure was significantly increased for ACPL of 6 mm compared with 0 mm. Decreased stem anteversion resulted in a significant reduction in both the maximum and mean surface pressure compared with native anteversion from 20° extension to the neutral position. Increased stem offset resulted in significant increases in the maximum and mean surface pressure of the iliopsoas muscle compared with decreased stem offset in 20° extension. Not only large ACPL but also changes in stem version and offset affected the maximum surface pressure of the iliopsoas muscle.
全髋关节置换术后髂腰肌撞击是由植入物刺激髂腰肌引起的，但髂腰肌的变化尚未进行定量评估。本研究评估了植入物对线改变时髂腰肌表面压力的变化。对 10 个新鲜冷冻尸体髋进行全髋关节置换术。我们评估了髋关节在 20°和 10°伸展、中立位和 10°屈曲时，前杯突出长度（ACPL）、柄版本和柄偏移变化时髂腰肌的最大和平均表面压力。当 ACPL 在 20°伸展时从 0、3 和 6mm 改变时，与 0mm 相比，6mm 的 ACPL 时最大表面压力显著增加。与从 20°伸展到中立位的天然前倾角相比，减小柄前倾角导致最大和平均表面压力显著降低。与 20°伸展时减小柄偏移相比，增加柄偏移会导致髂腰肌的最大和平均表面压力显著增加。不仅 ACPL 较大，而且柄版本和柄偏移的变化也会影响髂腰肌的最大表面压力。
