发育性髋关节发育不良全髋置换髋臼假体放置的研究进展

Advances of acetabular component placement in total hip replacement for developmental dysplasia of hip

发育性髋关节发育不良(DDH)通常为髋臼发育不良和股骨头畸形,使髋臼及股骨头匹配欠佳并发生异常的下肢力学传导,最终导致髋部疼痛及髋关节骨关节炎(HOA)的发生。全髋关节置换术(THA)是目前治疗晚期及重度成人DDH的首选方法,但由于髋臼结构的发育异常,包括髋臼前外侧骨缺损、髋臼前倾角增加等因素,术中安装髋臼杯的最佳位置及使其安装稳定的方法仍存争议。本文对THA治疗DDH时解剖位安装髋臼杯和适当上移安装髋臼杯的疗效进展进行综述,通过影像学分型、不同假体种类、生物力学、骨量和髋关节功能来为THA治疗DDH髋臼安装处理提供参考。

Developmental dysplasia of hip(DDH)usually associates with acetabular dysplasia and femoral head deformity.It causes a poor match between the acetabulum and the femoral head,which in turn leads to abnormal mechanotransduction in the lower limbs,eventually causing hip pain and developing hip osteoarthritis(HOA).(HOA).Total hip arthroplasty(THA)is currently the preferred method for advanced and severe adult DDH.However,because of the developmental abnormalities of the acetabular structure,including the anterolateral bony deficiency and the increased anteversion of the acetabulum,the optimal position of the acetabular cup and the methods of intraoperative stabilization remain controversial.This article reviewed the progress of the effect of installing acetabular cup between anatomical and lifted positions in THA,and provided references for installation and handling of acetabulum in the treatment of DDH with THA according to image classification,different types of prosthesis,biomechanics,bone mass and hip function.