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.	陈光兴, 古凌川, 杨柳, 等. 改良后外侧小切口全髋关节置换手术技术. 中华关节外科杂志(电子版), 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, 白荣杰, 杨文江. 髋关节置换术后并发症X线临床分析. 中国矫形外科杂志, 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.	赵菊环, 崔二峰, 张治礼. 全髋关节置换术后疗效及并发症的X线评价. 中国临床医学影像杂志, 2013, 24(2):143-145.
8.	王勇, 司刚, 蒋建农. 髋臼假体角度与全髋关节置换术后脱位的关系. 中国骨与关节损伤杂志, 2013, 28(12):1119-1121.
9.	吕作刚, 孔荣. 股骨偏心距变化可影响髋关节置换后相关并发症的发生. 中国组织工程研究, 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.	曾晖, Eckart Mayr, Michael Nogler, 等. 不同体位髋臼假体植入参照平面的测定及其临床意义. 中华实验外科杂志, 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.
19.	闫英杰, 朱龙, 程战伟, 等. 髋臼卵圆窝参照法在THR中髋臼假体旋转中心的疗效分析. 中华临床医师杂志(电子版), 2014, 8(7):1248-1252.
20.	曾春, 宋炎成, 蔡道章, 等. 全髋关节置换术治疗强直性脊柱炎髋关节骨性强直的临床研究. 中华关节外科杂志(电子版), 2010, 4(1):40-43.
21.	许杰, 马若凡, 蔡志清, 等. 髋臼发育不良者全髋置换中臼杯置入位置的力学分析. 中国临床解剖学杂志, 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.	张志奇, 傅明, 康焱, 等. 髋臼假体位置对人工股骨头应力分布的影响. 中华关节外科杂志(电子版), 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. 陈光兴, 古凌川, 杨柳, 等. 改良后外侧小切口全髋关节置换手术技术. 中华关节外科杂志(电子版), 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, 白荣杰, 杨文江. 髋关节置换术后并发症X线临床分析. 中国矫形外科杂志, 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. 赵菊环, 崔二峰, 张治礼. 全髋关节置换术后疗效及并发症的X线评价. 中国临床医学影像杂志, 2013, 24(2):143-145.
8. 王勇, 司刚, 蒋建农. 髋臼假体角度与全髋关节置换术后脱位的关系. 中国骨与关节损伤杂志, 2013, 28(12):1119-1121.
9. 吕作刚, 孔荣. 股骨偏心距变化可影响髋关节置换后相关并发症的发生. 中国组织工程研究, 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. 曾晖, Eckart Mayr, Michael Nogler, 等. 不同体位髋臼假体植入参照平面的测定及其临床意义. 中华实验外科杂志, 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.
19. 闫英杰, 朱龙, 程战伟, 等. 髋臼卵圆窝参照法在THR中髋臼假体旋转中心的疗效分析. 中华临床医师杂志(电子版), 2014, 8(7):1248-1252.
20. 曾春, 宋炎成, 蔡道章, 等. 全髋关节置换术治疗强直性脊柱炎髋关节骨性强直的临床研究. 中华关节外科杂志(电子版), 2010, 4(1):40-43.
21. 许杰, 马若凡, 蔡志清, 等. 髋臼发育不良者全髋置换中臼杯置入位置的力学分析. 中国临床解剖学杂志, 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. 张志奇, 傅明, 康焱, 等. 髋臼假体位置对人工股骨头应力分布的影响. 中华关节外科杂志(电子版), 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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