Imaging features of hip joint in patients with ankylosing spondylitis undergoing total hip arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Ke ¹ , LI Heng ^2△ , SUN Fenglong ¹ , LI Xiang ² , ZHANG Qingmeng ² , XU Chi ² , SONG Xinggui ² ,  CHEN Jiying ²

1. Department of Orthopedics, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, 100144, P.R.China;
2. Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853, P.R.China;

Corresponding?author：

CHEN Jiying, Email: chenjiying_301@163.com

Keywords：

Ankylosing spondylitis; CT three-dimensional reconstruction; imaging features; total hip arthroplasty

DOI：

10.7507/1002-1892.201610088

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To study the imaging features of the hip joint by measuring the imaging parameters of spine, pelvis, and hip joint before and after total hip arthroplasty (THA) in patients with ankylosing spondylitis (AS) undergoing THA so as to provide reference for selection of operation methods and prosthesis. Methods Between January and July 2015, 38 patients (56 hips) with AS underwent primary THA as AS group, and 36 patients (45 hips) with osteonecrosis of the femoral head underwent THA as control group. There was no significant difference in side (χ²=1.14,P=0.95). The acetabular abduction angle (ABA), acetabular anteversion angle (AVA), center collum diaphyseal (CCD), offset, height from rotation center to lesser trochanter (HRCLT), femoral intertrochanteric distance (FID) were measured by CT three-dimensional morphology. The canal flare index (CFI), cortical thickness index (CTI), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured by X-ray film before operation. The AVA, ABA, and the filling ratio were measured on the postoperative X-ray film. Results There was no significant difference in preoperative AVA and ABA and postoperative ABA between 2 groups (P>0.05), but significant difference was found in postoperative AVA (t=6.71,P=0.00). The mean PI, SS, and PT in AS group were 48.37° (range, 41-58°), 5.64°(range, 2-11°), and 12.85° (range, 5-26°), respectively. There was significant difference in CCD, CFI, and CTI between 2 groups (t=3.63,P=0.04;t=5.12,P=0.02;t=3.91,P=0.04), but offset, HRCLT, and FID all showed no significant difference (t=0.41,P=0.36;t=0.33,P=0.56;t=0.59,P=0.12). On the basis of the Noble classification, medullary cavity of the femur was rated as chimney type, ordinary type, and champagne flute type in 32, 18, and 6 hips of AS group, and in 4, 28, and 13 hips of control group respectively. Filling ratio of distal segment in AS group was significantly lower than that in control group (t=5.64,P=0.02), but there was no significant difference in the filling ratio of middle and proximal segments between 2 groups (t=0.29,P=0.61;t=0.55,P=0.13). Conclusion Compared with patients having osteonecrosis of the femeral head, there is no significant difference in preoperative AVA and ABA, but postoperative AVA significantly increase in patients with AS. Because AS patients have mainly chimney type medullary cavity of the femur, the filling ratio of middle and distal segment is lower when tapered stems are used, and the filling ratio of anatomic stems is higher.

Citation： LI Ke, LI Heng, SUN Fenglong, LI Xiang, ZHANG Qingmeng, XU Chi, SONG Xinggui, CHEN Jiying. Imaging features of hip joint in patients with ankylosing spondylitis undergoing total hip arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(3): 290-294. doi: 10.7507/1002-1892.201610088 Copy

1.	?李珂, 張慶猛, 李恒, 等. 強直性脊柱炎與非炎性髖關節疾病行人工全髖關節置換術的圍手術期炎癥指標比較. 中國修復重建外科雜志, 2015, 29(10): 1199-1203.
2.	Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet, 2007, 370(9597): 1508-1519.
3.	Ye C, Liu R, Sun J,et al. Cementless bilateral synchronous total hip arthroplasty in ankylosing spondylitis with hip ankylosis. Int Orthop, 2014, 38(12): 2473-2476.
4.	Gondusky JS, Pinkos KA, Choi L,et al. Simultaneous bilateral anterior approach total hip arthroplasty. Orthopedics, 2015, 38(7): e611-615.
5.	Rakow A, Simon P, Perka C. Hip arthroplasty in the presence of proximal femoral deformity. Orthopade, 2015, 44(7): 510-522.
6.	Hafez MA, Ragheb G, Hamed A,et al. Digital templating for THA: a simple computer-assisted application for complex hip arthritis cases. Biomed Tech (Berl), 2016, 61(5): 519-524.
7.	Rubin PJ, Leyvraz PF, Aubaniac JM,et al. The morphology of the proximal femur. A three-dimensional radiographic analysis. J Bone Joint Surg (Br), 1992, 74(1): 28-32.
8.	Tang WM, Chiu KY. Primary total hip arthroplastyin patients with ankylosing spondylitis. J Arthroplasty, 2000, 15(1): 52-58.
9.	Moll JM, Wright V. New York clinical criteria for ankylosing spondylitis. A statistical evaluation. Ann Rheum Dis, 1973, 32(4): 354-363.
10.	Olmedo-Garcia N, Lopez-Prats F, Agullo A,et al. A comparative study of the accuracy of Ranawat’s and Pierchon’s methods to determine the centre of rotation in bilateral coxopathy. Skeletal Radiol, 2000, 29(11): 652-655.
11.	Noble PC, Alexander JW, Lindahl LJ,et al. The anatomic basis of femoral component design. Clin Orthop Relat Res, 1988, (235): 148-165.
12.	Sah AP, Thornhill TS, LeBoff MS,et al. Correlation of plain radiographic indices of the hip with quantitative bone mineral density. Osteoporos Int, 2007, 18(8): 1119-1126.
13.	Vaz G, Roussouly P, Berthonnaud E,et al. Sagittal morphology and equilibrium of pelvis and spine. Eur Spine J, 2002, 11(1): 80-87.
14.	Kim YH, Kim V. Uncemented porous-coated anatomic total hip replacement. Results at six years in a consecutive series. J Bone Joint Surg (Br), 1993, 75(1): 6-13.
15.	Teloken MA, Bisset G, Hozack WJ,et al. Ten to fifteen-year follow-up after total hip arthroplasty with a tapered cobalt-chromium femoral component (tri-lock) inserted without cement. J Bone Joint Surg (Am), 2002, 84-A(12): 2140-2144.
16.	范新成, 劉峰, 魏開斌, 等. 多層螺旋 CT 三維重建測量髖臼外展角及前傾角的實驗研究. 中華臨床醫師雜志(電子版), 2014, 8(3): 122-126.
17.	Lewinnek GE, Lewis JL, Tarr R,et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg (Am), 1978, 60(2): 217-220.
18.	Baumg?rtner R, Heeren N, Quast D,et al. Is the cortical thickness index a valid parameter to assess bone mineral density in geriatric patients with hip fractures? Arch Orthop Trauma Surg, 2015, 135(6): 805-810.
19.	張仕凱, 孫俊英, 田家祥, 等. 生物型人工全髖關節置換術治療青年強直性脊柱炎髖關節病變的中期療效. 中國修復重建外科雜志, 2013, 27(2): 243-244.
20.	Lacko M, Schreierová D, ?ellár R,et al. Bone remodelling in the proximal femur after uncemented total hip arthroplasty in patients with osteoporosis. Acta Chir Orthop Traumatol Cech, 2015, 82(6): 430-436.
21.	劉宏偉, 顧衛東, 孫俊英. 應用矩形截面錐形股骨假體行人工全髖關節置換的中期療效. 中國修復重建外科雜志, 2013, 27(5): 594-598.

1. ?李珂, 張慶猛, 李恒, 等. 強直性脊柱炎與非炎性髖關節疾病行人工全髖關節置換術的圍手術期炎癥指標比較. 中國修復重建外科雜志, 2015, 29(10): 1199-1203.
2. Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet, 2007, 370(9597): 1508-1519.
3. Ye C, Liu R, Sun J,et al. Cementless bilateral synchronous total hip arthroplasty in ankylosing spondylitis with hip ankylosis. Int Orthop, 2014, 38(12): 2473-2476.
4. Gondusky JS, Pinkos KA, Choi L,et al. Simultaneous bilateral anterior approach total hip arthroplasty. Orthopedics, 2015, 38(7): e611-615.
5. Rakow A, Simon P, Perka C. Hip arthroplasty in the presence of proximal femoral deformity. Orthopade, 2015, 44(7): 510-522.
6. Hafez MA, Ragheb G, Hamed A,et al. Digital templating for THA: a simple computer-assisted application for complex hip arthritis cases. Biomed Tech (Berl), 2016, 61(5): 519-524.
7. Rubin PJ, Leyvraz PF, Aubaniac JM,et al. The morphology of the proximal femur. A three-dimensional radiographic analysis. J Bone Joint Surg (Br), 1992, 74(1): 28-32.
8. Tang WM, Chiu KY. Primary total hip arthroplastyin patients with ankylosing spondylitis. J Arthroplasty, 2000, 15(1): 52-58.
9. Moll JM, Wright V. New York clinical criteria for ankylosing spondylitis. A statistical evaluation. Ann Rheum Dis, 1973, 32(4): 354-363.
10. Olmedo-Garcia N, Lopez-Prats F, Agullo A,et al. A comparative study of the accuracy of Ranawat’s and Pierchon’s methods to determine the centre of rotation in bilateral coxopathy. Skeletal Radiol, 2000, 29(11): 652-655.
11. Noble PC, Alexander JW, Lindahl LJ,et al. The anatomic basis of femoral component design. Clin Orthop Relat Res, 1988, (235): 148-165.
12. Sah AP, Thornhill TS, LeBoff MS,et al. Correlation of plain radiographic indices of the hip with quantitative bone mineral density. Osteoporos Int, 2007, 18(8): 1119-1126.
13. Vaz G, Roussouly P, Berthonnaud E,et al. Sagittal morphology and equilibrium of pelvis and spine. Eur Spine J, 2002, 11(1): 80-87.
14. Kim YH, Kim V. Uncemented porous-coated anatomic total hip replacement. Results at six years in a consecutive series. J Bone Joint Surg (Br), 1993, 75(1): 6-13.
15. Teloken MA, Bisset G, Hozack WJ,et al. Ten to fifteen-year follow-up after total hip arthroplasty with a tapered cobalt-chromium femoral component (tri-lock) inserted without cement. J Bone Joint Surg (Am), 2002, 84-A(12): 2140-2144.
16. 范新成, 劉峰, 魏開斌, 等. 多層螺旋 CT 三維重建測量髖臼外展角及前傾角的實驗研究. 中華臨床醫師雜志(電子版), 2014, 8(3): 122-126.
17. Lewinnek GE, Lewis JL, Tarr R,et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg (Am), 1978, 60(2): 217-220.
18. Baumg?rtner R, Heeren N, Quast D,et al. Is the cortical thickness index a valid parameter to assess bone mineral density in geriatric patients with hip fractures? Arch Orthop Trauma Surg, 2015, 135(6): 805-810.
19. 張仕凱, 孫俊英, 田家祥, 等. 生物型人工全髖關節置換術治療青年強直性脊柱炎髖關節病變的中期療效. 中國修復重建外科雜志, 2013, 27(2): 243-244.
20. Lacko M, Schreierová D, ?ellár R,et al. Bone remodelling in the proximal femur after uncemented total hip arthroplasty in patients with osteoporosis. Acta Chir Orthop Traumatol Cech, 2015, 82(6): 430-436.
21. 劉宏偉, 顧衛東, 孫俊英. 應用矩形截面錐形股骨假體行人工全髖關節置換的中期療效. 中國修復重建外科雜志, 2013, 27(5): 594-598.

Chinese Journal of Reparative and Reconstructive Surgery

Imaging features of hip joint in patients with ankylosing spondylitis undergoing total hip arthroplasty

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content