骨盆倾斜与髋臼假体方向的关系研究  

Study on the Relation between Pelvic Tilt and the Orientation of Acetabular Prosthesis

作　　者：张志勇[1] 夏庆[2] 邵云潮[2] 朱兴元[1] 王晓峰[2] 

机构地区：[1]江苏省大丰市人民医院骨科,江苏大丰224100 [2]复旦大学附属中山医院骨科,上海200032

出　　处：《中国临床医学》2014年第4期421-423,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:研究在髋臼发育不良(development dysplasia ofhip,DDH)继发骨关节炎患者中,骨盆倾斜与髋臼假体安放角度的关系。方法:2008年1月—2012年12月在复旦大学附属中山医院因DDH继发骨关节炎而行初次全髋关节置换术(total hip arthroplasty,THA)的患者353例,将其中89例骨盆倾斜者纳入研究。89例中,脊柱固定畸形者按功能位安放髋臼假体,其他按解剖位置安放髋臼假体。结果:89例中76例患者随访超过1年,术后按功能位测量,平均外展角(41.4±6.5)度;按解剖位测量,平均外展角(37.9±6.3)度。76例均无脱位或感染。1例CrowⅣ型DDH假体移位,术后14个月进行了翻修。结论:骨盆倾斜在全髋关节置换术中是影响髋臼方向的一个重要因素,在安放髋臼假体时应评估未来可能的变化,错误的髋臼方向可能导致髋关节不稳定并增加磨损。Objective：To investigate the relationship between pelvic tilt and the orientation of acetabular prosthesis in patients with osteoarthritis caused by development dysplasia of hip（DDH）.Methods：From January 2008 to December 2012,353 patients with osteoarthritis caused by DDH underwent primary total hip arthroplasty （THA） in Zhongshan Hospital,Fudan University.Among them,there were 89 cases with pelvic tilt,who were enrolled in this study.Acetabular prosthesis followed the functional orientation in the patients with fixed spine deformity,and the anatomical orientation in the others.Results：Among the 89 patients,76 cases have been followed up for more than 1 year.The average abduction angle of the acetabulum is （41.4 ± 6.5）° according to the functional orientation,and （37.9 ± 6.3）° according to the anatomical orientation.There was no infection or dislocation in all cases.There was displacement of acetabular prosthesis in one case with Crow Ⅳ DDH,and it was revised 14 months after the first operation.Conclusions：Pelvic tilt is a critical factor influencing on the orientation of the acetabulum in THA.The probable future changes should be evaluated.Improper acetabular orientation may result in unstableness and increase wear.

关 键 词：前瞻性研究 Ⅳ级证据 髋臼发育不良 

分 类 号：R681.1[医药卫生—骨科学]