EFFECT OF REFORMATIVE ACETABULAR CENTRALIZATION TECHNOLOGY ON LEG-LENGTH INEQUALITY IN TOTAL HIP ARTHROPLASTY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CAOLinhu ,  TANLun , WUChao , LINXu , GUOYong , LUOXiaozhong , LIUShiwei

Department of Orthopedics, the Affiliated Zigong Hospital of Luzhou Medical College(the Fourth People's Hospital of Zigong City), Zigong Sichuan, 643000, P. R. China;

Corresponding author：

TANLun, Email: 1098726536@qq.com

Keywords：

Total hip arthroplasty; Acetabular centralization technology; Leg-length inequality

DOI：

10.7507/1002-1892.20140046

Video：

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Objective To investigate the application value of acetabular centralization technology for correction of leg-length inequality in total hip arthroplasty (THA). Methods Between June 2001 and January 2012, 147 cases of abnormal acetabular center were treated. Of them, 68 cases underwent routine THA (control group), and 79 cases underwent acetabular reconstruction by fossae ovalis oriented centralized technology in THA (test group). There was no significant difference in gender, age, side, pathogeny, acetabular rotation center indexs, difference of relative and absolute leg-length, and Harris score between 2 groups before operation (P>0.05). The hip joint function was evaluated by Harris score; the difference of relative leg-length was measured by tape; the difference of absolute leg-length and the horizontal and vertical distances of actual and true rotation center were also measured on the X-ray films by software. Results The patients were followed up 8-26 months (mean, 8.3 months) in the test group, and 6-33 months (mean, 9.7 months) in the control group. Sciatic nerve injury occurred in 2 cases (1 in each group, respectively), lower extremity deep venous thrombosis in 7 cases (3 in test group and 4 in control group), and hip joint dislocation in 2 cases (control group); the other patients had no related complications. The difference of relative leg-length and Harris score in test group were significantly better than in control group (P<0.05), and significant difference was also found when compared with preoperative one in 2 groups (P<0.05). The horizontal and vertical distances of actual and the true rotation center in test group was significantly better than those in control group at immediate after operation on the X-ray films (P<0.05); and significant differences were also found when compared with preoperative ones in 2 groups (P<0.05). At 6 months after operation, the absolute leg-length difference in test group was significantly better than that in control group (P<0.05); and significant difference was also found when compared with preoperative one in 2 groups (P<0.05). Conclusion The fossae ovalis oriented acetabular centralized technology in THA can significantly correct abnormal hip center of rotation, thus reduce the relative and absolute leg-length inequality and improve the life quality of the patients.

Citation： CAOLinhu, TANLun, WUChao, LINXu, GUOYong, LUOXiaozhong, LIUShiwei. EFFECT OF REFORMATIVE ACETABULAR CENTRALIZATION TECHNOLOGY ON LEG-LENGTH INEQUALITY IN TOTAL HIP ARTHROPLASTY. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(2): 213-217. doi: 10.7507/1002-1892.20140046 Copy

1.	Khanduja V,Tek V,Scott G.The effect of a neck-retaining femoral implant on leg-length inequality following total hip arthroplasty:a radiological study.J Bone Joint Surg (Br),2006,88(6):712-715.
2.	陈宜,吴宇黎,祝云利,等.股骨颈组配式假体在全髋关节置换术后偏心距重建中的作用.中华骨科杂志,2013,33(9):901-905.
3.	丛锐军,符培亮,吴宇黎,等.下肢重建方式对Crowe Ⅳ型髋关节发育不良全髋关节置换术后疗效的影响.中华骨科杂志,2013,33(3):214-219.
4.	张学军,王宸.数字化模板测量对全髋关节置换后下肢不等长的影响.中国组织工程研究,2013,17(9):1527-1534.
5.	李军伟,邱贵兴,翁习生,等.髋关节发育不良继发骨关节炎患者的人工全髋关节置换.中华外科杂志,2005,43(4):255-258.
6.	Konyves A,Bannister GC.The importance of leg length discrepancy after total hip arthroplasty.J Bone Joint Surg (Br),2005,87(2):155-157.
7.	Kjellberg M,Al-Amiry B,Englund E,et al.Measurement of leg length discrepancy after total hip arthroplasty.The reliability of a plain radiographic method compared to CT-scanogram.Skeletal Radiol,2012,41(2):187-191.
8.	Govsa F,Ozer MA,Ozgur Z.Morphologic features of the acetabulum.Arch Orthop Trauma Surg,2005,125(7):453-461.
9.	李军伟,杨广辉,王义生,等.髋臼卵圆窝在实现术前预期髋臼杯外展角中的参考价值.中华骨科杂志,2012,32(2):167-172.
10.	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.
11.	Edeen J,Sharkey PF,Alexander AH.Clinical significance of leg-length inequality after total hip arthroplasty.Am J Orthop (Belle Mead NJ),1995,24(4):347-351.
12.	杨勇,程涛,张先龙,等.全髋关节置换术后下肢不等长对功能和步态的影响.中华关节外科杂志(电子版),2013,7(1):60-63.
13.	王本杰,赵德伟,郭林,等.全髋关节置换术治疗成人髋关节发育不良的髋臼重建.中国骨与关节外科,2010,3(3):210-214.
14.	Dandachli W,Nakhla A,Iranpeur F,et al.Can the acetabular position be derived from a pelvic frame of reference? Clin Orthop Relat Res,2009,467(4):886-893.
15.	李雄峰,管国华,李建有.髋关节发育不良人工全髋关节置换术中髋臼中心重建.中国修复重建外科杂志,2012,26(9):1037-1040.
16.	Yoo MC,Cho YJ,Kim KI,et al.Cementless total hip arthroplasty with medial wall osteotomy for the sequelae of septic arthritis of the hip.Clin Orthop Surg,2009,1(1):19-26.
17.	Patel S,Thakrar RR,Bhamra J,et al.Are leg length and hip offset comparable after hip resurfacing and cementless total hip arthroplasty? Ann R Coll Surg Engl,2011,93(6):465-469.
18.	Brown NM,Foran JR,Della Valle CJ.Hip resurfacing and conventional THA:comparison of acetabular bone stock removal,leg length,and offset.Orthopedics,2013,36(5):e637-641.

1. Khanduja V,Tek V,Scott G.The effect of a neck-retaining femoral implant on leg-length inequality following total hip arthroplasty:a radiological study.J Bone Joint Surg (Br),2006,88(6):712-715.
2. 陈宜,吴宇黎,祝云利,等.股骨颈组配式假体在全髋关节置换术后偏心距重建中的作用.中华骨科杂志,2013,33(9):901-905.
3. 丛锐军,符培亮,吴宇黎,等.下肢重建方式对Crowe Ⅳ型髋关节发育不良全髋关节置换术后疗效的影响.中华骨科杂志,2013,33(3):214-219.
4. 张学军,王宸.数字化模板测量对全髋关节置换后下肢不等长的影响.中国组织工程研究,2013,17(9):1527-1534.
5. 李军伟,邱贵兴,翁习生,等.髋关节发育不良继发骨关节炎患者的人工全髋关节置换.中华外科杂志,2005,43(4):255-258.
6. Konyves A,Bannister GC.The importance of leg length discrepancy after total hip arthroplasty.J Bone Joint Surg (Br),2005,87(2):155-157.
7. Kjellberg M,Al-Amiry B,Englund E,et al.Measurement of leg length discrepancy after total hip arthroplasty.The reliability of a plain radiographic method compared to CT-scanogram.Skeletal Radiol,2012,41(2):187-191.
8. Govsa F,Ozer MA,Ozgur Z.Morphologic features of the acetabulum.Arch Orthop Trauma Surg,2005,125(7):453-461.
9. 李军伟,杨广辉,王义生,等.髋臼卵圆窝在实现术前预期髋臼杯外展角中的参考价值.中华骨科杂志,2012,32(2):167-172.
10. 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.
11. Edeen J,Sharkey PF,Alexander AH.Clinical significance of leg-length inequality after total hip arthroplasty.Am J Orthop (Belle Mead NJ),1995,24(4):347-351.
12. 杨勇,程涛,张先龙,等.全髋关节置换术后下肢不等长对功能和步态的影响.中华关节外科杂志(电子版),2013,7(1):60-63.
13. 王本杰,赵德伟,郭林,等.全髋关节置换术治疗成人髋关节发育不良的髋臼重建.中国骨与关节外科,2010,3(3):210-214.
14. Dandachli W,Nakhla A,Iranpeur F,et al.Can the acetabular position be derived from a pelvic frame of reference? Clin Orthop Relat Res,2009,467(4):886-893.
15. 李雄峰,管国华,李建有.髋关节发育不良人工全髋关节置换术中髋臼中心重建.中国修复重建外科杂志,2012,26(9):1037-1040.
16. Yoo MC,Cho YJ,Kim KI,et al.Cementless total hip arthroplasty with medial wall osteotomy for the sequelae of septic arthritis of the hip.Clin Orthop Surg,2009,1(1):19-26.
17. Patel S,Thakrar RR,Bhamra J,et al.Are leg length and hip offset comparable after hip resurfacing and cementless total hip arthroplasty? Ann R Coll Surg Engl,2011,93(6):465-469.
18. Brown NM,Foran JR,Della Valle CJ.Hip resurfacing and conventional THA:comparison of acetabular bone stock removal,leg length,and offset.Orthopedics,2013,36(5):e637-641.

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EFFECT OF REFORMATIVE ACETABULAR CENTRALIZATION TECHNOLOGY ON LEG-LENGTH INEQUALITY IN TOTAL HIP ARTHROPLASTY

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