Effect of restoration of combined offset on stability of large head THA
Effect of restoration of combined offset on stability of large head THA
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DOI：
10.5301/hip.2012.9283
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发表时间：
2012-05-01
影响因子：
1.5
通讯作者：
Westrich, Geoffrey
中科院分区：
文献类型：
--
作者：
Robinson, Michael;Bornstein, Lindsey;Westrich, Geoffrey
关节面技术的改进减少了磨损，增大了股骨头以降低脱位率。我们回顾性分析了668例初次全髋关节置换术（580例患者），通过后路入路植入32 mm或36 mm股骨头（2003年1月至2007年6月）并进行后路修复。患者接受了评估不稳定和脱位的问卷调查。我们比较了有无脱位患者的临床和影像学资料。平均随访3.4年（范围2-6.6年）。脱位率为1.3%（9/668）。降低术后偏心距（外侧偏心距+内侧偏心距测量值）和使用外径大于58 mm的髋臼杯会增加脱位风险。在所研究的所有髋关节的上四分位数和下四分位数中，大多数脱位的髋关节的组合偏置角和外展角为负。应使用适当的定位，以最大限度地降低插入大股骨头的THA的脱位风险。
Improvements in bearing technology have resulted in a reduction in wear and larger femoral heads to reduce dislocation rates. We retrospectively reviewed 668 primary THAs (580 patients) inserted with 32 mm or 36 mm femoral heads (1/2003-6/2007) performed through a posterior approach with posterior repair. Patients received a questionnaire assessing instability and dislocations. We compared clinical and radiographic data between patients with and without dislocations. Follow-up averaged 3.4 years (range 2-6.6 years). The dislocation rate was 1.3% (9/668). Decreasing the combined postoperative offset (lateral offset + medial offset measurements) and using acetabular cups larger than 58 mm in outer diameter increased the risk of dislocation. A majority of the hips that dislocated had negative combined offset and abduction angles in the upper and lower quartiles of all hips studied. Appropriate positioning should be used to minimise dislocation risk in THAs inserted with large femoral heads.