Patient Obesity Influences Pelvic Lift During Cup Insertion in Total Hip Arthroplasty Through a Lateral Transgluteal Approach in Supine Position
Patient Obesity Influences Pelvic Lift During Cup Insertion in Total Hip Arthroplasty Through a Lateral Transgluteal Approach in Supine Position
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DOI：
10.1016/j.arth.2017.04.021
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发表时间：
2017-09-01
影响因子：
3.5
通讯作者：
Matziolis, Georg
中科院分区：
文献类型：
--
作者：
Brodt, Steffen;Nowack, Dimitri;Matziolis, Georg
背景：全髋关节置换术（THA）植入过程中骨盆的移动对髋臼杯的定位有重要影响。牵开器引起的强牵引导致医源性骨盆提升，因此可能是髋臼杯错位的部分原因。本研究的目的是调查这些因素的影响骨盆lift.Methods：骨盆的动态运动的测量过程中植入THA在67例患者。这是通过使用智能手机上的SensorLog应用程序测量加速度来完成的。结果：在最大值时，骨盆平均提升6.7度。当撞击压配式髋臼杯时，手术侧与皮肤切开时相比升高4.4 °。这升降机在杯植入的时间显着相关的身体质量指数和病人的腹部和骨盆circumstance.Conclusion：每一个外科医生进行THA必须意识到骨盆升降机在操作过程中。特别是在体重指数高、腹围大或骨盆围大的患者中，髋臼杯错位的风险增加。当撞击髋臼杯时，我们建议释放牵开器的牵引力，以便骨盆能够倾斜回到其自然位置，从而尽可能准确地实现预期的髋臼杯定位。(C)2017爱思唯尔公司All rights reserved.
Background: Movement of the pelvis during implantation of total hip arthroplasty (THA) has a major influence on the positioning of the acetabular cup. Strong traction caused by retractors leads to iatrogenic pelvic lift and can thus be partly responsible for cup malpositioning. The objective of this study was to investigate such factors that influence pelvic lift.Methods: The dynamic movement of the pelvis was measured during implantation of THA in 67 patients. This was done by measuring the acceleration using the SensorLog app on a smartphone.Results: At its maximum, the pelvis was lifted by an average of 6.7 degrees. When impacting the press-fit cup, the surgical side was raised by 4.4 degrees compared with the time of skin incision. This lift at the time of cup implantation correlates significantly with the body mass index and the patient's abdominal and pelvic circumference.Conclusion: Every surgeon performing THA must be aware of the pelvic lift during an operation. Especially in patients with a high body mass index, a large abdominal circumference, or a large pelvic circumference, there is an increased risk of malpositioning of the acetabular cup. When impacting the cup, we recommend releasing the traction of the retractor, so that the pelvis can tilt back into its natural position, and thus, the anticipated cup positioning can be implemented as exactly as possible. (C) 2017 Elsevier Inc. All rights reserved.