RESEARCH OF ACETABULAR ORIENTATION DETERMINATION AND ACCURACY IN TOTAL HIP ARTHROPLASTY FOR BONY ANKYLOSED HIP_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

FUYingxu , YANGDesheng ,  Asihaerjiang·Maimaitiyiming , CAOLi , GUOwentao

Department of Joint Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830000, P. R. China;

Corresponding?author：

Asihaerjiang·Maimaitiyiming, Email: askar660525@126.com

Keywords：

Bony ankylosed hip; Total hip arthroplasty; Acetabular orientation

DOI：

10.7507/1002-1892.20150092

Video：

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Objective To explore the method of acetabular orientation determination in total hip arthroplasty (THA) for bony ankylosed hip and the accuracy of the postoperative evaluation. Methods Between January 2009 and March 2013, 33 consecutive patients (49 hips) underwent THA. There were 25 males and 8 females with a mean age of 35.8 years (range, 18-69 years). The left hip was involved in 10 cases, the right hip in 7 cases, and bilateral hips in 16 cases. The causes were ankylosing spondylitis in 18 patients, tuberculosis in 6 patients, traumatic arthritis in 6 patients, osteoarthritis in 2 patients, and suppurative infection in 1 patient. The disease duration was 7-15 years with an average of 10.8 years. The acetabular orientation was determined with periacetabular bone marks (the upper margin of the obturator foramen, acetabular notch etc.) and soft tissue signs (acetabulum transverse ligament etc.). The hip or pelvic radiograph was taken to measure the acetabular prosthesis anteversion and abduction angle, and upward or downward, inward or outward acetabular migration degree. The acetabular anteversion angle of 15 degrees, the abduction angle of 45 degrees, and upward or downward, inward or outward acetabular migration degree of 0 served as a reference value to evaluate the accuracy of acetabular position. Results There was no complications of neurovascular injury, fracture, joint dislocation, and infection. All of patients were followed up 13-63 months (mean, 30.3 months). The anteversion angle and abduction angle were (13.904±4.034)° and (42.898±7.474)° at last follow-up, showing no significant difference when compared with reference value (t=1.386, P=0.178; t=1.969, P=0.055). The inward or outward and upward or downward acetabulum migration degree were (2.530±2.261) mm and (3.886±3.334) mm respectively, showing significant differences when compared with reference value (t=7.830, P=0.000; t=8.159, P=0.000); it was less than 5 mm in 29 hips, 5-10 mm in 18 hips, and more than 10 mm in 2 hips; the acetabulum center coincidence rate was 59.2%. Conclusion For bony ankylosed hip having loss of normal anatomy structure, intraoperative residues and permanent anatomical structure should be used for acetabular positioning.

Citation： FUYingxu, YANGDesheng, Asihaerjiang·Maimaitiyiming, CAOLi, GUOwentao. RESEARCH OF ACETABULAR ORIENTATION DETERMINATION AND ACCURACY IN TOTAL HIP ARTHROPLASTY FOR BONY ANKYLOSED HIP. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(4): 426-430. doi: 10.7507/1002-1892.20150092 Copy

1.	陳光興, 古凌川, 楊柳, 等. 改良后外側小切口全髖關節置換手術技術. 中華關節外科雜志(電子版), 2008, 2(3):16-20.
2.	Pradhan R. Planar anteversion of the acetabular cup as determined from plain anteroposterior radiographs. J Bone Joint Surg (Br), 1999, 81(3):431-435.
3.	Ranawat CS, Dorr LD, Inglis AE. Total hip arthroplasty in protrusio acetabuli of rheumatoid arthritis. J Bone Joint Surg (Am), 1980, 62(7)1059-1065.
4.	夏同敬, 白榮杰, 楊文江. 髖關節置換術后并發癥X線臨床分析. 中國矯形外科雜志, 2012, 20(3):275-277.
5.	Zahar A, Rastogi A, Kendoff D. Dislocation after total hip arthroplasty. Curr Rev Musculoskelet Med, 2013, 6(4):350-356.
6.	Daines BK, Dennis DA. The importance of acetabular component position in total hip arthroplasty. Orthop Clin North Am, 2012, 43(5):e23-34.
7.	趙菊環, 崔二峰, 張治禮. 全髖關節置換術后療效及并發癥的X線評價. 中國臨床醫學影像雜志, 2013, 24(2):143-145.
8.	王勇, 司剛, 蔣建農. 髖臼假體角度與全髖關節置換術后脫位的關系. 中國骨與關節損傷雜志, 2013, 28(12):1119-1121.
9.	呂作剛, 孔榮. 股骨偏心距變化可影響髖關節置換后相關并發癥的發生. 中國組織工程研究, 2012, 16(13):2309-2312.
10.	Austin MS, Rothman RH. Acetabular orientation:anterolateral approach in the supine position. Clin Orthop Relat Res, 2009, 467(1):112-118.
11.	Li J, Wang Z, Li M, et al. Total hip arthroplasty using a combined anterior and posterior approach via a lateral incision in patients with ankylosed hips. Can J Surg, 2013, 56(5):332-340.
12.	曾暉, Eckart Mayr, Michael Nogler, 等. 不同體位髖臼假體植入參照平面的測定及其臨床意義. 中華實驗外科雜志, 2004, 21(10):1259-1261.
13.	Blondel B, Parratte S, Tropiano P, et al. Pelvic tilt measurement before and after total hip arthroplasty. Orthop Traumatol Surg Res, 2009, 95(8):568-572.
14.	Taki N, Mitsugi N, Mochida Y, et al. Change in pelvic tilt angle 2 to 4 years after total hip arthroplasty. J Arthroplasty, 2012, 27(6):940-944.
15.	Meftah M, Yadav A, Wong AC, et al. A novel method for accurate and reproducible functional cup positioning in total hip arthroplasty. J Arthroplasty, 2013, 28(7):1200-1205.
16.	McCollum DE, Gray WJ. Dislocation after total hip arthroplasty. Causes and prevention. Clin Orthop Relat Res, 1990, (261):159-170.
17.	Sotereanos NG, Miller MC, Smith B, et al. Using intraoperative pelvic landmarks for acetabular component placement in total hip arthroplasty. J Arthroplasty, 2006, 21(6):832-840.
18.	李軍偉, 楊廣輝, 王義生, 等. 髖臼卵圓窩在實現術前預期髖臼杯外展角中的參考價值. 中華骨科雜志, 2012, 32(2):167-172.
19.	閆英杰, 朱龍, 程戰偉, 等. 髖臼卵圓窩參照法在THR中髖臼假體旋轉中心的療效分析. 中華臨床醫師雜志(電子版), 2014, 8(7):1248-1252.
20.	曾春, 宋炎成, 蔡道章, 等. 全髖關節置換術治療強直性脊柱炎髖關節骨性強直的臨床研究. 中華關節外科雜志(電子版), 2010, 4(1):40-43.
21.	許杰, 馬若凡, 蔡志清, 等. 髖臼發育不良者全髖置換中臼杯置入位置的力學分析. 中國臨床解剖學雜志, 2014, 32(3):343-347.
22.	Nie Y, Pei F, Li Z. Effect of high hip center on stress for dysplastic hip. Orthopedics, 2014, 37(7):e637-e643.
23.	Philippe R, Gosselin O, Sedaghatian J, et al. Acetabular reconstruction using morselized allograft and a reinforcement ring for revision arthroplastywith Paprosky type Ⅱ and Ⅲ bone loss:Survival analysis of 95 hips after 5 to 13 years. Orthop Traumatol Surg Res, 2012, 98(2):129-137.
24.	張志奇, 傅明, 康焱, 等. 髖臼假體位置對人工股骨頭應力分布的影響. 中華關節外科雜志(電子版), 2008, 2(6):667-671.
25.	Pagnano W, Hanssen AD, Lewallen DG, et al. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg (Am), 1996, 78(7):1004-1014.
26.	Nunn D, Freeman MA, Hill PF, et al. The measurement of migration of the acetabular component of hip prostheses. JBone Joint Surg (Br), 1989, 71(4):629-631.

1. 陳光興, 古凌川, 楊柳, 等. 改良后外側小切口全髖關節置換手術技術. 中華關節外科雜志(電子版), 2008, 2(3):16-20.
2. Pradhan R. Planar anteversion of the acetabular cup as determined from plain anteroposterior radiographs. J Bone Joint Surg (Br), 1999, 81(3):431-435.
3. Ranawat CS, Dorr LD, Inglis AE. Total hip arthroplasty in protrusio acetabuli of rheumatoid arthritis. J Bone Joint Surg (Am), 1980, 62(7)1059-1065.
4. 夏同敬, 白榮杰, 楊文江. 髖關節置換術后并發癥X線臨床分析. 中國矯形外科雜志, 2012, 20(3):275-277.
5. Zahar A, Rastogi A, Kendoff D. Dislocation after total hip arthroplasty. Curr Rev Musculoskelet Med, 2013, 6(4):350-356.
6. Daines BK, Dennis DA. The importance of acetabular component position in total hip arthroplasty. Orthop Clin North Am, 2012, 43(5):e23-34.
7. 趙菊環, 崔二峰, 張治禮. 全髖關節置換術后療效及并發癥的X線評價. 中國臨床醫學影像雜志, 2013, 24(2):143-145.
8. 王勇, 司剛, 蔣建農. 髖臼假體角度與全髖關節置換術后脫位的關系. 中國骨與關節損傷雜志, 2013, 28(12):1119-1121.
9. 呂作剛, 孔榮. 股骨偏心距變化可影響髖關節置換后相關并發癥的發生. 中國組織工程研究, 2012, 16(13):2309-2312.
10. Austin MS, Rothman RH. Acetabular orientation:anterolateral approach in the supine position. Clin Orthop Relat Res, 2009, 467(1):112-118.
11. Li J, Wang Z, Li M, et al. Total hip arthroplasty using a combined anterior and posterior approach via a lateral incision in patients with ankylosed hips. Can J Surg, 2013, 56(5):332-340.
12. 曾暉, Eckart Mayr, Michael Nogler, 等. 不同體位髖臼假體植入參照平面的測定及其臨床意義. 中華實驗外科雜志, 2004, 21(10):1259-1261.
13. Blondel B, Parratte S, Tropiano P, et al. Pelvic tilt measurement before and after total hip arthroplasty. Orthop Traumatol Surg Res, 2009, 95(8):568-572.
14. Taki N, Mitsugi N, Mochida Y, et al. Change in pelvic tilt angle 2 to 4 years after total hip arthroplasty. J Arthroplasty, 2012, 27(6):940-944.
15. Meftah M, Yadav A, Wong AC, et al. A novel method for accurate and reproducible functional cup positioning in total hip arthroplasty. J Arthroplasty, 2013, 28(7):1200-1205.
16. McCollum DE, Gray WJ. Dislocation after total hip arthroplasty. Causes and prevention. Clin Orthop Relat Res, 1990, (261):159-170.
17. Sotereanos NG, Miller MC, Smith B, et al. Using intraoperative pelvic landmarks for acetabular component placement in total hip arthroplasty. J Arthroplasty, 2006, 21(6):832-840.
18. 李軍偉, 楊廣輝, 王義生, 等. 髖臼卵圓窩在實現術前預期髖臼杯外展角中的參考價值. 中華骨科雜志, 2012, 32(2):167-172.
19. 閆英杰, 朱龍, 程戰偉, 等. 髖臼卵圓窩參照法在THR中髖臼假體旋轉中心的療效分析. 中華臨床醫師雜志(電子版), 2014, 8(7):1248-1252.
20. 曾春, 宋炎成, 蔡道章, 等. 全髖關節置換術治療強直性脊柱炎髖關節骨性強直的臨床研究. 中華關節外科雜志(電子版), 2010, 4(1):40-43.
21. 許杰, 馬若凡, 蔡志清, 等. 髖臼發育不良者全髖置換中臼杯置入位置的力學分析. 中國臨床解剖學雜志, 2014, 32(3):343-347.
22. Nie Y, Pei F, Li Z. Effect of high hip center on stress for dysplastic hip. Orthopedics, 2014, 37(7):e637-e643.
23. Philippe R, Gosselin O, Sedaghatian J, et al. Acetabular reconstruction using morselized allograft and a reinforcement ring for revision arthroplastywith Paprosky type Ⅱ and Ⅲ bone loss:Survival analysis of 95 hips after 5 to 13 years. Orthop Traumatol Surg Res, 2012, 98(2):129-137.
24. 張志奇, 傅明, 康焱, 等. 髖臼假體位置對人工股骨頭應力分布的影響. 中華關節外科雜志(電子版), 2008, 2(6):667-671.
25. Pagnano W, Hanssen AD, Lewallen DG, et al. The effect of superior placement of the acetabular component on the rate of loosening after total hip arthroplasty. J Bone Joint Surg (Am), 1996, 78(7):1004-1014.
26. Nunn D, Freeman MA, Hill PF, et al. The measurement of migration of the acetabular component of hip prostheses. JBone Joint Surg (Br), 1989, 71(4):629-631.

Chinese Journal of Reparative and Reconstructive Surgery

RESEARCH OF ACETABULAR ORIENTATION DETERMINATION AND ACCURACY IN TOTAL HIP ARTHROPLASTY FOR BONY ANKYLOSED HIP

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