Pour Aidin Eslam, Green Jordan H, Christensen Thomas H, Muthusamy Nishanth, Schwarzkopf Ran
Department of Orthopaedic Surgery, Yale University, New Haven, CT, USA.
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
Arthroplast Today. 2023 May 17;21:101133. doi: 10.1016/j.artd.2023.101133. eCollection 2023 Jun.
Many of the current total hip arthroplasty (THA) planning tools only consider sagittal pelvic tilt in the standing and relaxed sitting positions. Considering that the risk of postoperative dislocation is higher when bending forward or in sit-to-stand move, sagittal pelvic tilt in the flexed seated position may be more relevant for preoperative planning. We hypothesized that there was a significant difference in sagittal pelvic tilt between the relaxed sitting and flexed seated positions as measured by the sacral slope in preoperative and postoperative full-body radiographs.
This was a multicenter retrospective analysis of the preoperative and postoperative simultaneous biplanar full-body radiographs of 93 primary THA patients in standing, relaxed sitting, and flexed seated positions. The sagittal pelvic tilt was measured using the sacral slope relative to the horizontal line.
The mean difference between the preoperative sacral slope in the relaxed sitting position and the flexed seated position was 11.3° (-13° to 43°) ( < .0001). This difference was >10° in 52 patients (56%) and >20° in 18 patients (19.4%). The mean difference between the postoperative sacral slope in a relaxed sitting position and the sacral slope in a flexed seated position was 11.3° ( < .0001). This difference was >10° in 51 patients (54.9%) and >30° in 14 patients (15.1%) postoperatively.
There was a significant difference in sagittal pelvic tilt between the relaxed and flexed seated positions. A flexed seated view provides valuable information that might be more relevant for preoperative THA planning in order to prevent postoperative THA instability.
当前许多全髋关节置换术（THA）规划工具仅考虑站立位和放松坐姿时的矢状面骨盆倾斜度。鉴于向前弯曲或从坐姿到站立动作时术后脱位风险更高，屈曲坐姿时的矢状面骨盆倾斜度可能与术前规划更相关。我们假设，通过术前和术后全身X线片上的骶骨斜率测量，放松坐姿和屈曲坐姿之间的矢状面骨盆倾斜度存在显著差异。
这是一项对93例初次THA患者术前和术后同时拍摄的站立位、放松坐姿和屈曲坐姿双平面全身X线片的多中心回顾性分析。使用相对于水平线的骶骨斜率测量矢状面骨盆倾斜度。
术前放松坐姿和屈曲坐姿时骶骨斜率的平均差异为11.3°（-13°至43°）（P<0.0001）。52例患者（56%）的该差异>10°，18例患者（19.4%）的该差异>20°。术后放松坐姿时的骶骨斜率与屈曲坐姿时的骶骨斜率的平均差异为11.3°（P<0.0001）。术后51例患者（54.9%）的该差异>10°，14例患者（15.1%）的该差异>30°。
放松坐姿和屈曲坐姿之间的矢状面骨盆倾斜度存在显著差异。屈曲坐姿视图提供了有价值的信息，这可能与术前THA规划更相关，以防止术后THA不稳定。
