Orthopaedic Unit, S. Andrea Hospital, University of Rome, "La Sapienza" Via Di Grottarossa 1035, Rome, Italy.
Int Orthop. 2023 Nov;47(11):2737-2742. doi: 10.1007/s00264-023-05899-3. Epub 2023 Aug 5.
The respect of native hip offset represents a mainstay for satisfying results in total hip arthroplasty (THA). Historically, a great interest has been focused on restoration of femoral offset, while only in recent years, acetabular offset (AO) has been considered. The purpose of the current study was to compare the "single-use peripheral" reaming technique with the "conventional" one for the maintenance of the native COR of the hip and AO in patients undergoing to primary THA.
Eighty patients affected from primary hip osteoarthritis were prospectively enrolled in the study and were divided in two groups (Group A "single-use peripheral" and Group B "conventional" reaming technique). Pre- and post-operatively, AO, acetabular floor distance (AFd) and acetabular version (AV) were assessed through a CT scan. A comparison between groups for the radiological parameters, surgical time and complications was performed.
The demographic data were similar in both groups. The complications rate and the AV did not differ statistically between groups. Group A presented a statistically significant shorter surgical time and lower variation between pre- and post-operative AO and AFd. Statistical significance was defined as p < 0.05.
The "single-use peripheral" reaming technique demonstrated to be more reliable in reproducing the native COR and AO of patients undergoing to primary THA than the "conventional" one. The operative time was significantly reduced, and it may lead to a reduction in the infection risk even though it was not observed in the current study. Further research could be useful to validate such findings and to assess clinical impact and long-term survival of the implant.
尊重原生髋偏移是全髋关节置换术(THA)获得满意效果的主要因素。从历史上看,人们对股骨偏心距的恢复非常关注,而直到近年来,髋臼偏心距(AO)才受到关注。本研究的目的是比较“单次使用外周”扩孔技术与“常规”扩孔技术在接受初次 THA 的患者中维持髋关节固有 COR 和 AO 的效果。
前瞻性纳入 80 例原发性髋关节骨关节炎患者,并将其分为两组(A 组“单次使用外周”扩孔技术和 B 组“常规”扩孔技术)。通过 CT 扫描评估术前和术后的 AO、髋臼底距(AFd)和髋臼角(AV)。对两组的影像学参数、手术时间和并发症进行比较。
两组的人口统计学数据相似。两组之间的并发症发生率和 AV 无统计学差异。A 组的手术时间明显缩短,术前和术后 AO 及 AFd 的变化也更小,具有统计学意义(p<0.05)。
与“常规”扩孔技术相比,“单次使用外周”扩孔技术在复制初次 THA 患者的固有 COR 和 AO 方面更可靠。手术时间明显缩短,尽管本研究中未观察到,但可能会降低感染风险。进一步的研究可能有助于验证这些发现,并评估植入物的临床效果和长期存活率。