Roy Adam E, Carrier Charles S, Schwab Pierre-Emmanuel, Thornhill Thomas S, Losina Elena, Chen Antonia F, Katz Jeffrey N, Lange Jeffrey K
Harvard Combined Orthopaedic Residency Program, Boston, Massachusetts.
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
J Arthroplasty. 2023 Dec;38(12):2630-2633. doi: 10.1016/j.arth.2023.05.074. Epub 2023 Jun 4.
Spino-pelvic orientation may affect dislocation risk following total hip arthroplasty (THA). It can be measured on lateral lumbo-pelvic radiographs. The sacro-femoro-pubic (SFP) angle, measured on an antero-posterior (AP) pelvis radiograph, is a reliable proxy for pelvic tilt, a measurement of spino-pelvic orientation measured on a lateral lumbo-pelvic radiograph. The purpose of this study was to investigate the relationship between SFP angle and dislocation following THA.
An Institutional Review Board-approved retrospective case-control study was conducted at a single academic center. We matched 71 dislocators (cases) to 71 nondislocators (controls) following THA performed by 1 of 10 surgeons between September 2001 and December 2010. Two authors (readers) independently calculated SFP angle from single preoperative AP pelvis radiographs. Readers were blinded to cases and controls. Conditional logistic regressions were used to identify factors differentiating cases and controls.
The data did not show a clinically relevant or statistically significant difference in SFP angles after adjusting for gender, American Society of Anesthesiologists classification, prosthetic head size, age at time of THA, measurement laterality, and surgeon.
We did not find an association between preoperative SFP angle and dislocation following THA in our cohort. Based on our data, SFP angle as measured on a single AP pelvis radiograph should not be used to assess dislocation risk prior to THA.
脊柱-骨盆方向可能会影响全髋关节置换术(THA)后脱位的风险。它可以通过腰骶骨盆侧位X线片进行测量。在骨盆前后位(AP)X线片上测量的骶股耻骨(SFP)角是骨盆倾斜的可靠替代指标,骨盆倾斜是在腰骶骨盆侧位X线片上测量的脊柱-骨盆方向的一种测量方法。本研究的目的是探讨THA后SFP角与脱位之间的关系。
在一个学术中心进行了一项经机构审查委员会批准的回顾性病例对照研究。我们将2001年9月至2010年12月期间由10名外科医生之一进行THA后的71例脱位患者(病例)与71例未脱位患者(对照)进行匹配。两位作者(阅片者)独立地从术前单张骨盆AP X线片中计算SFP角。阅片者对病例和对照情况不知情。采用条件逻辑回归来确定区分病例和对照的因素。
在对性别、美国麻醉医师协会分级、假体头大小、THA时的年龄、测量侧别和外科医生进行调整后,数据未显示SFP角在临床上有相关差异或统计学上的显著差异。
在我们的队列中,我们未发现术前SFP角与THA后脱位之间存在关联。根据我们的数据,在单张骨盆AP X线片上测量的SFP角不应在THA前用于评估脱位风险。