Pagnano W, Hanssen A D, Lewallen D G, Shaughnessy W J
Department of Orthopedic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
J Bone Joint Surg Am. 1996 Jul;78(7):1004-14. doi: 10.2106/00004623-199607000-00004.
A method for measurement of the true acetabular region and the approximate femoral head center as well as a classification consisting of four zones for assessment of the acetabular position of the acetabular cup were used to analyze the results of primary total hip arthroplasty with cement in 117 patients (145 hips). All patients had Crowe type-II congenital dysplasia of the hip. The mean age at the time of the arthroplasty was fifty-one years (range, fifteen to seventy-six years), and the mean duration of follow-up was fourteen years (range, two to twenty-two years). The initial position of the acetabular cup outside of the true acetabular region and outside of zone 1 (inferior and medial) was associated with an increase in the rates of loosening (p < 0.05) and revision (p < 0.04) of the femoral components. Cups that initially were more than fifteen millimeters superior to the approximate femoral head center, without lateral displacement, were associated with an increased rate of loosening (p < 0.001) and of revision (p < 0.04) of the femoral components as well as with an increased rate of loosening (p < 0.002) and of revision (p < 0.01) of the acetabular components. These findings suggest that superior positioning of the acetabular component, even without lateral displacement, leads to increased rates of loosening of the femoral and acetabular components. An attempt should be made to position the acetabular component in or near the true acetabular region.
采用一种测量真髋臼区域和近似股骨头中心的方法以及一种由四个区域组成的用于评估髋臼杯髋臼位置的分类方法，对117例患者（145髋）的初次骨水泥型全髋关节置换术结果进行分析。所有患者均为Crowe II型先天性髋关节发育不良。置换术时的平均年龄为51岁（范围15至76岁），平均随访时间为14年（范围2至22年）。髋臼杯初始位置位于真髋臼区域之外且位于1区（下方和内侧）之外，与股骨组件松动率（p < 0.05）和翻修率（p < 0.04）增加相关。初始位置比近似股骨头中心高出超过15毫米且无侧向移位的髋臼杯，与股骨组件松动率（p < 0.001）和翻修率（p < 0.04）增加以及髋臼组件松动率（p < 0.002）和翻修率（p < 0.01）增加相关。这些发现表明，即使没有侧向移位，髋臼组件的高位放置也会导致股骨和髋臼组件松动率增加。应尝试将髋臼组件放置在真髋臼区域内或附近。
