Comparison between cup implantations during total hip arthroplasty with or without a history of rotational acetabular osteotomy
Comparison between cup implantations during total hip arthroplasty with or without a history of rotational acetabular osteotomy
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有或没有髋臼旋转截骨史的全髋关节置换术期间杯植入的比较
DOI：
10.1007/s00402-021-04253-9
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发表时间：
2021
影响因子：
2.3
通讯作者：
Tanaka Sakae
中科院分区：
文献类型：
--
作者：
Tanaka Takeyuki;Moro Toru;Asai Shin;Hashikura Kazuaki;Ishikura Hisatoshi;Tanaka Sakae
简介由于 RAO 后髋臼形态特征，髋臼旋转截骨术 (RAO) 后的全髋关节置换术 (THA) 在技术上要求很高。本研究旨在探讨RAO后THA与初次THA之间三维髋臼杯位置的差异。材料和方法我们分析了2017年1月至2018年6月期间接受THA的120例患者（RAO后20例，无RAO病史100例）的术前和术后CT数据。我们评估了放射学参数，包括髋臼前倾角、前后距离根据 CT 数据，在 RAO 期间，股骨头中心水平处存在前髋臼骨赘和/或旋转碎片。此外，还评估了手术数据和临床评分。结果虽然我们发现任何临床参数没有显着差异，但放射学参数和手术数据存在显着差异。与植入髋臼相比，RAO 术后患者的髋臼形态明显后倾，前后距离更长。此外，此类患者需要更长的手术时间。这些结果反映了RAO后髋臼的非典型形态，并强调应注意避免前部骨撞击和术后脱位。结论对于RAO后THA期间的髋臼杯植入，外科医生应认识到髋臼的非典型形态，不要被其视觉形状所误导。
IntroductionTotal hip arthroplasty (THA) after rotational acetabular osteotomy (RAO) is technically demanding because of the characteristic acetabular morphology after RAO. The present study aimed to investigate the differences in the three-dimensional cup position between THA after RAO and primary THA.Materials and methodsWe analysed the pre-operative and post-operative computed tomography (CT) data of 120 patients (20 patients after RAO and 100 patients without a history of RAO) who underwent THA between January 2017 and June 2018. We evaluated radiographic parameters, including acetabular anteversion, antero-posterior distance at the level of the femoral head centre, the presence of anterior acetabular osteophyte and/or rotated fragment during RAO from the CT data. Additionally, operative data and clinical scores were also evaluated.ResultsAlthough we found no significant differences in any clinical parameters, there were significant differences in radiographic parameters and operative data. The morphology of the acetabulum was significantly retroverted, and the antero-posterior distance was longer in patients after RAO, compared to the implanted cup. Additionally, longer operative time was necessary for such patients. These results reflect the atypical acetabular morphology after RAO, and emphasize that care should be taken to avoid anterior bony impingement and post-operative dislocation.ConclusionFor cup implantation during THA after RAO, surgeons should acknowledge the atypical morphology of the acetabulum and not be misled by its visual shape.