Abstract:Objective To explore the influence of the posterolateral approach and the direct anterior approach on the position of the prosthesis stem and the analysis of the factors affecting the anteversion angle of the femur in the initial total hip arthroplasty.Methods A total of 108 cases of 114 hip joints were included in our hospital from June 2015 to June 2020 in which the same doctor used an anatomical stem for the first total hip replacement.The flexion range of the affected hip was less than 60°,the lower extremity needs to be extended more than 2 cm,the BMI was more than 30 kg/m2 and the patient requires the posterolateral approach to use the posterolateral approach approach,the rest of the patients use the posterolateral approach approach,posterolateral approach group has 44 cases of hips,male There were 24 hips and 20 female hips,with an average age of (60.1±12.1)years.There were 70 hips in the posterolateral approach group,of which 38 were male hips and 32 were female hips,with an average age of (59.8±11.4)years.The patient lies in the supine position,CT scans the affected side (anterior superior iliac spine to tibial tubercle),reconstructs the three-dimensional figure of the femur,and measures the position of the femoral prosthetic stem in the sagittal,coronal and horizontal planes,anteversion angle,and osteotomy from the lesser tuberosity Distance and the anteroposterior distance of the femoral head.Results Before the operation,the anteversion angle of the femur was (23.2±10.4)° in the posterolateral approach group and (27.7±10.9)° in the posterolateral approach group.The difference between the two groups was statistically significant (P=0.003).The postoperative femoral anteversion angles of the two groups were (28.5±11.5)° and (30.7±9.2)°,respectively,and the difference was not statistically significant (P=0.141).After the comparison of the changes in the anteversion angle between the two groups,the difference was statistically significant (P=0.043);the difference between the sagittal and sagittal angles of the prosthesis was statistically significant (P=0.008,P=0.003).The preoperative anteversion angle was related to the postoperative anteversion angle,and the difference was statistically significant (P=0.001);the difference between posterolateral approach approach flexion implantation and posterolateral approach approach implantation was statistically significant (P=0.043);femoral head There was no statistically significant difference in the changes of the front-to-back distance between the two approaches (P=0.882).Conclusion The preoperative femoral anteversion angle is a factor that affects the postoperative anteversion angle.The surgical approach does not affect the postoperative anteversion angle and the change of the femoral head's anteroposterior distance.The surgical approach affects the position of the prosthesis stem in the sagittal plane.
唐宇,刘俊才,陈建,陈畅,程宇翔,李忠,陈歌 *. 初次全髋关节置换术中后外侧入路与直接前方入路对解剖柄位置的影响[J]. 实用骨科杂志, 2021, 27(2): 97-102.
Tang Yu,Liu Juncai,Chen Jian,et al. The Influence of Posterolateral Approach and Direct Anterior Approach on the Position of Anatomic Stems During Primary Total Hip Replacement. sygkzz, 2021, 27(2): 97-102.
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