Department of Orthopedics, School of Medicine, Jinling Hospital, Nanjing University, Nanjing, Jiangsu, China.
Laboratory of Tissue and Transplant in Anhui Province, Department of Orthopedics, The First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu, Anhui, China.
Sci Rep. 2023 Apr 15;13(1):6185. doi: 10.1038/s41598-023-33501-8.
The aim of this study was to explore a novel method to determine the orientation of acetabular prosthesis in total hip arthroplasty (THA) by refering to the anatomical landmarker of acetabular notches. Forty-one normal developmental hips were included in the present study. The acetabulums were reamed according to standard surgical procedures of THA on life-size 3D printing pelvis models. The inferior edge of acetabular cup were placed (1-5) mm proximal and distal to the proximal line of the anterior and posterior acetabular notches (PLAPAN) respectively to determine cup inclination. The inferior edge of acetabular cup were placed (1-5) mm pronating and supinating around the proximal point of acetabular posterior notch (PPAPN) respectively to determine cup anteversion. The pelvis plain radiographs were took and the inclination and anteversion of the acetabular cup at 22 positions were calculated. In the normal developmental hip, the mean inclination of acetabular prothesis were (35.10 ± 3.22)° and (45.90 ± 2.68)° when the inferior edge of the acetabular cup was 3 mm proximal and 1 mm distal to the PLAPAN. The optimal cup inclination could be obtained when the inferior edge of the acetabular cup was 1 mm proximal to the PLAPAN (the mean inclination was (40.71 ± 2.80)°). The mean anteversion of acetabular prothesis were (10.67 ± 4.55)° and (20.86 ± 4.44)° when the inferior edge of the acetabular cup was 1 mm pronating and 1 mm supinating around the PPAPN. The optimal cup anteversion could be obtained when the inferior edge of the acetabular cup was parallel to the PLAPAN (the mean anteversion was (18.00 ± 1.64)°). The inclination and anteversion of acetabular prosthesis could be determined by refering the anatomical landmarks of acetabular notches, which could help orthopedists to install the acetabular prosthesis quickly and safely in THA.
本研究旨在探讨一种通过参照髋臼切迹的解剖学标志来确定全髋关节置换术(THA)中髋臼假体方向的新方法。本研究纳入了 41 个正常发育的髋关节。在真人大小的 3D 打印骨盆模型上,按照 THA 的标准手术程序扩髋臼。髋臼杯的下边缘分别位于髋臼前、后切迹近端线(PLAPAN)前、后 1-5mm 处以确定杯倾斜度。髋臼杯的下边缘分别在前、后髋臼切迹近端点(PPAPN)周围旋前、旋后 1-5mm 以确定杯前倾角。拍摄骨盆平片,计算髋臼杯在 22 个位置的倾斜度和前倾角。在正常发育的髋关节中,当髋臼杯的下边缘位于 PLAPAN 前 3mm 和后 1mm 处时,髋臼假体的平均倾斜度分别为(35.10±3.22)°和(45.90±2.68)°。当髋臼杯的下边缘位于 PLAPAN 前 1mm 时,可以获得最佳的杯倾斜度(平均倾斜度为(40.71±2.80)°)。当髋臼杯的下边缘在前、后髋臼切迹近端点周围分别旋前和旋后 1mm 时,髋臼假体的平均前倾角分别为(10.67±4.55)°和(20.86±4.44)°。当髋臼杯的下边缘与 PLAPAN 平行时,可以获得最佳的杯前倾角(平均前倾角为(18.00±1.64)°)。通过参照髋臼切迹的解剖学标志,可以确定髋臼假体的倾斜度和前倾角,这有助于骨科医生在 THA 中快速、安全地安装髋臼假体。