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.	陳宜,吳宇黎,祝云利,等.股骨頸組配式假體在全髖關節置換術后偏心距重建中的作用.中華骨科雜志,2013,33(9):901-905.
3.	叢銳軍,符培亮,吳宇黎,等.下肢重建方式對Crowe Ⅳ型髖關節發育不良全髖關節置換術后療效的影響.中華骨科雜志,2013,33(3):214-219.
4.	張學軍,王宸.數字化模板測量對全髖關節置換后下肢不等長的影響.中國組織工程研究,2013,17(9):1527-1534.
5.	李軍偉,邱貴興,翁習生,等.髖關節發育不良繼發骨關節炎患者的人工全髖關節置換.中華外科雜志,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.	李軍偉,楊廣輝,王義生,等.髖臼卵圓窩在實現術前預期髖臼杯外展角中的參考價值.中華骨科雜志,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.	楊勇,程濤,張先龍,等.全髖關節置換術后下肢不等長對功能和步態的影響.中華關節外科雜志(電子版),2013,7(1):60-63.
13.	王本杰,趙德偉,郭林,等.全髖關節置換術治療成人髖關節發育不良的髖臼重建.中國骨與關節外科,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,管國華,李建有.髖關節發育不良人工全髖關節置換術中髖臼中心重建.中國修復重建外科雜志,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. 陳宜,吳宇黎,祝云利,等.股骨頸組配式假體在全髖關節置換術后偏心距重建中的作用.中華骨科雜志,2013,33(9):901-905.
3. 叢銳軍,符培亮,吳宇黎,等.下肢重建方式對Crowe Ⅳ型髖關節發育不良全髖關節置換術后療效的影響.中華骨科雜志,2013,33(3):214-219.
4. 張學軍,王宸.數字化模板測量對全髖關節置換后下肢不等長的影響.中國組織工程研究,2013,17(9):1527-1534.
5. 李軍偉,邱貴興,翁習生,等.髖關節發育不良繼發骨關節炎患者的人工全髖關節置換.中華外科雜志,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. 李軍偉,楊廣輝,王義生,等.髖臼卵圓窩在實現術前預期髖臼杯外展角中的參考價值.中華骨科雜志,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. 楊勇,程濤,張先龍,等.全髖關節置換術后下肢不等長對功能和步態的影響.中華關節外科雜志(電子版),2013,7(1):60-63.
13. 王本杰,趙德偉,郭林,等.全髖關節置換術治療成人髖關節發育不良的髖臼重建.中國骨與關節外科,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,管國華,李建有.髖關節發育不良人工全髖關節置換術中髖臼中心重建.中國修復重建外科雜志,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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Chinese Journal of Reparative and Reconstructive Surgery

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

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