Ishii Seiya, Baba Tomonori, Hayashi Koju, Homma Yasuhiro, Mutou Osamu, Ishijima Muneaki
Department of Orthopaedic Surgery, Yokohama Tsurugamine Hospital, Kanagawa, Japan - Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo, Japan - Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.
SICOT J. 2024;10:48. doi: 10.1051/sicotj/2024045. Epub 2024 Nov 19.
Precise implant positioning during total hip arthroplasty (THA) is an important factor affecting dislocation rate and long-term implant survival. Although a special carbon fiber traction table for THA improves the accuracy of implant positioning, it is too expensive. We aimed to report the accuracy of cup positioning and complication rate in patients undergoing THA using a conventional noncarbon fiber traction table, which is generally used for osteosynthesis of femoral fractures.
This retrospective study included 62 patients who received primary THA via the direct anterior approach using a conventional traction table with fluoroscopy between July 2022 and December 2023. Two observers recorded radiological outcomes using postoperative anteroposterior X-rays. The intraclass correlation coefficients of cup positioning angles were evaluated (inclination: 0.92, anteversion: 0.88 for intra-observer agreement; inclination: 0.91, anteversion: 0.84 for inter-observer agreement). Complications were defined as dislocation, periprosthetic fracture, ankle fracture, implant loosening, nerve injury, surgical site infection, deep vein thrombosis, and revision surgery for any reason.
Radiographic analysis showed an average cup inclination of 38.5° ± 4.3° (98.4% within Lewinnek's safe zone). The average cup anteversion was 12.6° ± 4.6° (100% within Lewinnek's safe zone). None of the patients experienced any complications.
A conventional traction table could be a feasible alternative to a carbon fiber traction table for performing THA via the direct anterior approach using fluoroscopy at general hospitals.
全髋关节置换术（THA）中精确的植入物定位是影响脱位率和植入物长期生存率的重要因素。尽管一种用于THA的特殊碳纤维牵引台提高了植入物定位的准确性，但它过于昂贵。我们旨在报告使用传统的非碳纤维牵引台（通常用于股骨骨折的骨固定）进行THA的患者髋臼杯定位的准确性和并发症发生率。
这项回顾性研究纳入了2022年7月至2023年12月期间通过直接前路使用传统牵引台并在透视引导下接受初次THA的62例患者。两名观察者使用术后前后位X线片记录放射学结果。评估髋臼杯定位角度的组内相关系数（观察者内一致性：倾斜度为0.92，前倾角为0.88；观察者间一致性：倾斜度为0.91，前倾角为0.84）。并发症定义为脱位、假体周围骨折、踝关节骨折、植入物松动、神经损伤、手术部位感染、深静脉血栓形成以及因任何原因进行的翻修手术。
影像学分析显示髋臼杯平均倾斜度为38.5°±4.3°（98.4%在Lewinnek安全区内）。髋臼杯平均前倾角为12.6°±4.6°（100%在Lewinnek安全区内）。所有患者均未出现任何并发症。
在综合医院通过透视引导采用直接前路进行THA时，传统牵引台可能是碳纤维牵引台的一种可行替代方案。
