Prediction of Postoperative Stem Anteversion in Crowe Type II/III Developmental Dysplasia of the Hip on Preoperative Two-Dimensional Computed Tomography
Prediction of Postoperative Stem Anteversion in Crowe Type II/III Developmental Dysplasia of the Hip on Preoperative Two-Dimensional Computed Tomography
复制标题
术前二维计算机断层扫描预测克罗 II/III 型髋关节发育不良术后柄前倾
DOI：
10.1016/j.arth.2019.09.037
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发表时间：
2020-02-01
影响因子：
3.5
通讯作者：
Mao, Yuanqing
中科院分区：
文献类型：
--
作者：
Yu, Degang;Zeng, Yiming;Mao, Yuanqing
背景：术前计划是全髋关节置换术的基础。本研究探讨了最佳的股骨颈水平测量股骨前倾角预测术后干前倾发育不良的髋关节和确定的预测作用，平均前倾的基础上矢状面3点fixation.Methods：62 Crowe II/III型发育不良髋关节进行全髋关节置换术进行了回顾性分析。通过二维计算机断层扫描测量术前和术后前倾角。在股骨近端的6个节段测量前、后皮质前倾。计算每个节段的股骨前倾角。结果：从小转子到头颈交界处，股骨前倾角由大于股骨柄前倾角逐渐减小到小于股骨柄前倾角。对于股骨颈高度>= 10 mm的髋关节，小转子近端基底上方10 mm水平的股骨前倾角与股骨柄前倾角无显著差异，单楔形假体相关性良好，双楔形假体相关性极佳。平均前（小转子近端基部）和后皮质前倾（股骨颈在小转子近端基底上方10 mm处）与股骨柄前倾无显著差异，相关性良好。对于股骨颈高度>= 10 mm的Crowe II/III型髋关节，小转子近端基底上方10 mm水平是测量股骨前倾角以预测术后股骨柄前倾角的最佳选择。小转子处的前皮质前倾和股骨颈处的后皮质前倾的平均值具有预测作用。(c)2019爱思唯尔公司All rights reserved.
Background: Preoperative planning is fundamental for total hip arthroplasty. This study investigated the optimal femoral neck level for measuring femoral anteversion to predict postoperative stem anteversion in developmental dysplasia of the hip and determined the predictive role of average anteversion based on the sagittal 3-point fixation.Methods: Sixty-two Crowe type II/III dysplastic hips that underwent total hip arthroplasty were retrospectively analyzed. Preoperative and postoperative anteversion was measured via 2-dimensional computed tomography. Anterior and posterior cortex anteversions were measured at 6 levels of the proximal femur. Femoral anteversion at each level was calculated. Average anterior (lesser trochanter) and posterior cortex anteversions (femoral neck) were calculated based on the sagittal 3-point fixation.Results: From the lesser trochanter to head-neck junction, femoral anteversion decreased gradually from more to less than stem anteversion. For hips with femoral neck height >= 10 mm, femoral anteversion at the 10-mm level above the lesser trochanter proximal base showed no significant difference with stem anteversion, with a good correlation for the single-wedge and an excellent correlation for the double-wedge stem. Average anterior (lesser trochanter proximal base) and posterior cortex anteversions (femoral neck at 10 mm above the lesser trochanter proximal base) showed no significant difference from stem anteversion, with excellent correlations.Conclusion: For Crowe type II/III hips with femoral neck height >= 10 mm, the 10-mm level above the lesser trochanter proximal base is an optimal choice for measuring femoral anteversion to predict postoperative stem anteversion. The average of anterior cortex anteversion at the lesser trochanter and posterior cortex anteversion at the femoral neck has a predictive role. (c) 2019 Elsevier Inc. All rights reserved.