Objective： To study the influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations, which meets the criteria for desired range of motion （ROM） for activities of dail...Objective： To study the influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations, which meets the criteria for desired range of motion （ROM） for activities of daily living in total hip arthroplasty （THA）. Methods： A three-dimensional generic, parametric and kinematic simulation module of THA was developed to analyze the cup safe-zone and the optimum combination of cup and neck antetorsion. A ROM of flexion ≥ 120°, internal rotation ≥ 45° at 90° flexion, extension ≥ 30° and external rotation ≥ 40° was defined as the criteria for desired ROM for activities of daily living. The cup safe-zone was defined as the area that fulfills all the criteria of desired ROM before the neck impinged on the liner of the cup. For a fixed stemneck （CCD）-angle of 130°, theoretical safe-zones fulfilling the desired ROM were investigated at different general headneck ratios （GR=2, 2.17, 2.37, 2.61 and 2.92） and femoral anteversions （FA=0°, 10°, 20° and 30°）. Results： Large GRs greatly increased the size of safezones and when the CCD-angle was 130°, a GR〉2.37 could further increase the size of safe-zones. There was a complexinterplay between the orientation angles of the femoral and acetabular components. When the CCD-angle was 130°, the optimum relationship between operative acetabular anteversion （OA） and femoral antetorsion （FA） could be estimated by the formula： OA=-0.80×FA＋47.06, and the minimum allowable operative acetabular inclination （OImin） would be more than 2 10.5 ×GR^-2255. Conclusions： Large GRs greatly increase the size of safe-zones and it is recommended that the GR be more than 2.37 so as to extend the acceptable range of error that surgeons cannot avoid completely during operation. As to the optimum operative acetabular inclination （OI）, surgeons need to make a decision combining with other factors, including stress distribution, soft tissue and cup wear conditions, as well as patients＇ individual situations and demands. The data obtained from this study and the module of THA can be used to assist surgeons to choose and implant appropriate implants.展开更多
Objective: To study the clinical influence of femoral quality on cementless hip replacement and to evaluate cortical index (CI) for femoral quality in order to guide prosthesis choice and rehabilitation. Methods: Fort...Objective: To study the clinical influence of femoral quality on cementless hip replacement and to evaluate cortical index (CI) for femoral quality in order to guide prosthesis choice and rehabilitation. Methods: Forty nine cases of cementless hip replacement were followed up for average 3.5 years, 42 of whom had X ray films on preoperation or operation day. Results: Harris scores and patients satisfaction were low but pain was significant and prolonged when cortical indices were low. Conclusions: CI is a reliable semi quantity parameter for clinical evaluation of femoral quality. Osteoporosis patients predispose to thigh pain. Lag for full weight loading and avoidance for torsion motion can contribute to less pain when CI≤ 2.2 .展开更多
基金This work was supported by grants from Science Foundation from Sci-Tech Committee of Zhejiang Province （No. 2009C33144）, Science Foundation from Sci-Tech Committee of Wenzhou City （No. Y20070043） and Science Foundation from Sci-Tech Committee of Rui＇an City （No. 20082088）.
文摘Objective： To study the influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations, which meets the criteria for desired range of motion （ROM） for activities of daily living in total hip arthroplasty （THA）. Methods： A three-dimensional generic, parametric and kinematic simulation module of THA was developed to analyze the cup safe-zone and the optimum combination of cup and neck antetorsion. A ROM of flexion ≥ 120°, internal rotation ≥ 45° at 90° flexion, extension ≥ 30° and external rotation ≥ 40° was defined as the criteria for desired ROM for activities of daily living. The cup safe-zone was defined as the area that fulfills all the criteria of desired ROM before the neck impinged on the liner of the cup. For a fixed stemneck （CCD）-angle of 130°, theoretical safe-zones fulfilling the desired ROM were investigated at different general headneck ratios （GR=2, 2.17, 2.37, 2.61 and 2.92） and femoral anteversions （FA=0°, 10°, 20° and 30°）. Results： Large GRs greatly increased the size of safezones and when the CCD-angle was 130°, a GR〉2.37 could further increase the size of safe-zones. There was a complexinterplay between the orientation angles of the femoral and acetabular components. When the CCD-angle was 130°, the optimum relationship between operative acetabular anteversion （OA） and femoral antetorsion （FA） could be estimated by the formula： OA=-0.80×FA＋47.06, and the minimum allowable operative acetabular inclination （OImin） would be more than 2 10.5 ×GR^-2255. Conclusions： Large GRs greatly increase the size of safe-zones and it is recommended that the GR be more than 2.37 so as to extend the acceptable range of error that surgeons cannot avoid completely during operation. As to the optimum operative acetabular inclination （OI）, surgeons need to make a decision combining with other factors, including stress distribution, soft tissue and cup wear conditions, as well as patients＇ individual situations and demands. The data obtained from this study and the module of THA can be used to assist surgeons to choose and implant appropriate implants.
文摘Objective: To study the clinical influence of femoral quality on cementless hip replacement and to evaluate cortical index (CI) for femoral quality in order to guide prosthesis choice and rehabilitation. Methods: Forty nine cases of cementless hip replacement were followed up for average 3.5 years, 42 of whom had X ray films on preoperation or operation day. Results: Harris scores and patients satisfaction were low but pain was significant and prolonged when cortical indices were low. Conclusions: CI is a reliable semi quantity parameter for clinical evaluation of femoral quality. Osteoporosis patients predispose to thigh pain. Lag for full weight loading and avoidance for torsion motion can contribute to less pain when CI≤ 2.2 .
