Spinopelvic mobility and acetabular component position for total hip arthroplasty
Spinopelvic mobility and acetabular component position for total hip arthroplasty
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DOI：
10.1302/0301-620x.99b1.bjj-2016-0415.r1
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发表时间：
2017-01-01
影响因子：
4.6
通讯作者：
Dorr, L. D.
中科院分区：
文献类型：
--
作者：
Stefl, M.;Lundergan, W.;Dorr, L. D.
目的坐姿时骨盆后倾提供生物髋臼开口。我们的目标是研究术后骨骼活动度和矢状髋臼部件位置的相互作用。材料和方法这是一项对 160 个髋关节（151 名患者）进行的放射学研究，这些患者前瞻性地进行了侧位脊柱骨盆髋关节 X 光片以进行骨骼和植入物测量。术中髋臼假体位置根据术前脊柱活动度确定。使用矢状种植体前倾角和骶骨髋臼角的测量值作为撞击风险的替代测量值，并将术中髋臼组件角与这些进行比较。 结果术后，133 个髋关节（83.1%）的前倾角和骶骨髋臼角均在正常范围内。共有7个髋关节（4.4%）存在病理性失衡，并通过生物或手术融合髋关节。总之，24 个髋关节中的 23 个髋关节在术前危险的脊柱不平衡得到了纠正。结论 总共 160 个髋关节中的 145 个髋关节 (90%) 被认为不会受到撞击。风险最高的患者是那些接受生物或手术脊柱融合的患者；具有危险脊柱不平衡的患者可以安全地使用正确的髋臼假体位置。该研究的临床意义在于它将髋臼部件位置与脊柱骨盆活动度相关联，从而为全髋关节置换术提供了指导。
AimsPosterior tilt of the pelvis with sitting provides biological acetabular opening. Our goal was to study the post-operative interaction of skeletal mobility and sagittal acetabular component position.Materials and MethodsThis was a radiographic study of 160 hips (151 patients) who prospectively had lateral spinopelvic hip radiographs for skeletal and implant measurements. Intra-operative acetabular component position was determined according to the pre-operative spinal mobility. Sagittal implant measurements of ante-inclination and sacral acetabular angle were used as surrogate measurements for the risk of impingement, and intra-operative acetabular component angles were compared with these.ResultsPost-operatively, ante-inclination and sacral acetabular angles were within normal range in 133 hips (83.1%). A total of seven hips (4.4%) had pathological imbalance and were biologically or surgically fused hips. In all, 23 of 24 hips had pre-operative dangerous spinal imbalance corrected.ConclusionsIn all, 145 of 160 hips (90%) were considered safe from impingement. Patients with highest risk are those with biological or surgical spinal fusion; patients with dangerous spinal imbalance can be safe with correct acetabular component position. The clinical relevance of the study is that it correlates acetabular component position to spinal pelvic mobility which provides guidelines for total hip arthroplasty.