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大转子尖作为解剖学参考以最小化髋关节置换术后的肢体长度差异

Greater Trochanter Tip as an Anatomical Reference to Minimize Leg Length Discrepancy following Hip Arthroplasty.

作者信息

Butarbutar John Christian Parsaoran, Ivander Gian, Riantho Albert, Fidiasrianto Kevin, Edward Joshua, Tasya Earlene

机构信息

Department of Orthopaedics and Traumatology, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia.

Department of Orthopaedics and Traumatology, Siloam Hospitals Lippo Village, Tangerang, Indonesia.

出版信息

Hip Pelvis. 2024 Dec 1;36(4):302-309. doi: 10.5371/hp.2024.36.4.302.

Abstract

PURPOSE

The objective of the current study is to introduce a proposed method and evaluate its efficacy using the greater trochanter (GT) tip rather than the lesser trochanter (LT) as an anatomical landmark to reduce leg length discrepancy (LLD) during performance of hip arthroplasty.

MATERIALS AND METHODS

Thirty-two patients who underwent hip arthroplasty were divided according to the GT group (n=17) and the LT control group (n=11); four patients were excluded. LLD was determined by assessing the vertical lengths parallel to the line connecting the lower margin of the teardrop to the most prominent part of the LT on a standing anteroposterior pelvic X-ray taken 30 days after the procedure. The mean and median LLD of the two groups were compared. Analysis of planning for femoral stem depth insertion and postoperative results was also performed.

RESULTS

No significant differences in characteristics including age, sex, or body mass index were observed between the two groups. However, the type of arthroplasty differed significantly between groups (=0.016). The mean postoperative LLD was significantly smaller in the GT group compared with the control group (=0.004). The results of linear regression of femoral stem depth showed a significant association between intraoperative planning and postoperative measurement (t=2.705, =0.672, =0.016).

CONCLUSION

Preoperative measurement in determining femoral stem depth insertion using the GT tip as an anatomical reference can effectively minimize LLD in patients who underwent hip arthroplasty.

摘要

目的

本研究的目的是介绍一种建议的方法,并评估使用大转子(GT)尖而非小转子(LT)作为解剖标志在髋关节置换术中减少肢体长度差异(LLD)的疗效。

材料与方法

32例行髋关节置换术的患者根据GT组(n = 17)和LT对照组(n = 11)进行分组;排除4例患者。通过在术后30天站立位骨盆前后位X线片上评估平行于连接泪滴下缘至LT最突出部分的线的垂直长度来确定LLD。比较两组的平均和中位数LLD。还进行了股骨柄深度插入的规划分析和术后结果分析。

结果

两组在年龄、性别或体重指数等特征方面未观察到显著差异。然而,两组之间的关节置换类型差异显著(P = 0.016)。与对照组相比,GT组术后平均LLD显著更小(P = 0.004)。股骨柄深度的线性回归结果显示术中规划与术后测量之间存在显著关联(t = 2.705,R = 0.672,P = 0.016)。

结论

以GT尖作为解剖参考来确定股骨柄深度插入的术前测量可有效减少髋关节置换术患者的LLD。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff5/11638752/408e82a75957/hp-36-4-302-f1.jpg

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