髋臼假体角度与全髋关节置换术后脱位的关系

Effect of orientation of cup on dislocation after total hip arthroplasty

目的研究人工全髋关节置换术（THA）髋臼假体安装固定角度与术后髋关节脱位的关系。方法在X线片测量236例（248髋）THA术后的髋臼外展角和前倾角，将外展角设定为〈30°、30-50°、〉50°3组，前倾角设定为〈0°、0-25°、〉25°3组。分析以上2个因素与术后髋关节脱位的关系。结果脱位组外展角平均（39±11．88）°，非脱位组为（38．98±8．65）°，两组之间外展角差异无统计学意义（P=0．449）；脱位组前倾角平均（12．33±14．89）°，非脱位组为（13．21±11．52）°，两组之间前倾角差异无统计学意义（P=0．131）°外展角在〈30°、30-50°、〉50°不同范围的脱位率差异无统计学意义（P〉0．05），前倾角在〈0°、0～25°、〉25°不同范围内的脱位率差异无统计学意义（P〉0．05）。结论髋臼假体外展角在14～58°范围内、前倾角在-15～350范围内与THA术后脱位之间不存在相关性。

Objective To study the effect of orientation of the cup on dislocation after total hip arthroplasty （THA） which could be used as a basis to evaluate clinical practice. Methods Of whom 236 patients（248 hips） met the selected criteria and were evaluated in this study. The standardized anteroposterior radiographs of the hip and the cross-table lateral film of the hip were used for measuring of the abduction angle and the anteversion angle. The abduction angle was further classified as normal, if it was 30-50°; horizontal, if it was less than 30°; and vertical, if it was greater than 50°. The anteversion angle was also further classified as being anteverted （〉25°）, neutral （0-25°）, retroverted （〈0°）. Results In the patients who had a dislocation, the average acetabular component abduction angle was （39.00±11.88）°, whereas the average abduction angle for the other patients who did not dislocate was （38.98.00±8.65）°（P =0.449）. And the patients who had a dislocation, the average anteversion angle was （12.33±14.89）°, whereas the average anteversion angle for the patients who did not dislocate was （13.21 ±11.52）°（P =0.131）. There was no significant difference in the prevalence of dislocation between patients who were categorized as having a normal abduction angle（30-50°） and patients who had a vertical or horizontal angle（P 〉0.05）; And there also no significant difference between the anteversion angle（P 〉0.05）. Conclusion The aeetabular abduction angle from 14° to 58°and antevertion angle from -15°to 35°have no effect on dislocation after THA.