Application of modified acetabular anteversion and inclination angles test system in patients undergoing total hip arthroplasty after lumbar fusion_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XIONG Changjun ^1,2 , ZUO Yunzhou ^1,2 , YAN Xiaokang ^1,2 , WANG Guan ^1,2 , FU Hao ^1,2 ,  JIANG Xueming ^1,2

1. Department of Joint Surgery, Wuhan Integrated Traditional Chinese and Western Medicine Hospital, Wuhan Hubei, 430079, P. R. China;
2. Department of Joint Surgery, Wuhan Sports University Affiliated Hospital, Wuhan Hubei, 430079, P. R. China;

Corresponding?author：

JIANG Xueming, Email: 44456349@qq.com

Keywords：

Total hip arthroplasty; acetabular prosthesis; anteversion angle; inclination angle; lumbar fusion

DOI：

10.7507/1002-1892.202401001

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the accuracy and effectiveness of acetabular cup placement in total hip arthroplasty (THA) after lumbar fusion applying of modified acetabular anteversion and inclination angles test system. Methods A clinical data of 45 patients undergoing THA for osteoarthritis between January 2018 and June 2023 was retrospectively analyzed. All patients had previously received lumbar fusion. The modified acetabular anteversion and inclination angle test system was used in 26 cases (observation group) and not used in 19 cases (control group) during THA. There was no significant difference in baseline data such as gender, age, body mass index, operative side, number of lumbar fusion segments, and preoperative Harris score between the two groups (P>0.05). The position of acetabular prosthesis, hip function (Harris score), and incidence of complications were compared between the two groups.Results In the observation group, all acetabular cups were in the safe zone (anteversion angle, 25°-30°) during operation, and 1 acetabular cup (3.85%) was not in the safe zone after operation. In the control group, 9 acetabular cups (47.37%) were not in the safe zone. The postoperative difference between the two groups was significant (P<0.05). There was no significant difference between intra- and post-operative acetabular inclination angles in the observation group (P>0.05), and the postoperative acetabular inclination angle was significantly smaller in the observation group than in the control group (P<0.05). All incisions healed by first intention and no infection occurred. All patients were followed up 6 months. There was no significant difference in Harris score between the two groups at different time point (P>0.05), and there were significant differences between different time points in the two groups (P<0.05). No joint dislocation occurred in the observation group during follow-up, while dislocation occurred in 2 cases and femoral impingement syndrome occurred in 1 case of the control group. There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion For THA patients with lumbar fusion, the ideal placement angle of the acetabular cup can be obtained by using the modified acetabular anteversion and inclination angles test system during operation.

Citation： XIONG Changjun, ZUO Yunzhou, YAN Xiaokang, WANG Guan, FU Hao, JIANG Xueming. Application of modified acetabular anteversion and inclination angles test system in patients undergoing total hip arthroplasty after lumbar fusion. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(5): 576-582. doi: 10.7507/1002-1892.202401001 Copy

1.	董佩龍, 唐曉波, 王健, 等. 兩種入路全髖關節置換術治療老年股骨頸骨折的療效比較. 臨床骨科雜志, 2022, 25(4): 477-481.
2.	梁慶晨, 孫鳳龍, 王宏慶, 等. 磁導航脊柱內鏡下腰椎融合術治療單節段腰椎退行性疾病的療效觀察. 中國脊柱脊髓雜志, 2023, 33(8): 707-714, 723.
3.	Miyagi M, Fukushima K, Inoue G, et al. Hip-spine syndrome: cross-sectional-study of spinal alignment in patients with coxalgia. Hip Int, 2019, 29(1): 21-25.
4.	Haffer H, Wang Z, Hu Z, et al. Effect of coronal and sagittal spinal malalignment on spinopelvic mobility in patients undergoing total hip replacement: a prospective observational study. Clin Spine Surg, 2022, 35(6): E510-E519.
5.	Lewinnek GE, Lewis JL, Tarr R, et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg (Am), 1978, 60(2): 217-220.
6.	Grammatopoulos G, Falsetto A, Sanders E, et al. Integrating the combined sagittal index reduces the risk of dislocation following total hip replacement. J Bone Joint Surg (Am), 2022, 104(5): 397-411.
7.	Tezuka T, Heckmann ND, Bodner RJ, et al. Functional safe zone is superior to the lewinnek safe zone for total hip arthroplasty: why the lewinnek safe zone is not always predictive of stability. J Arthroplasty, 2019, 34(1): 3-8.
8.	Seagrave KG, Troelsen A, Malchau H, et al. Acetabular cup position and risk of dislocation in primary total hip arthroplasty. Acta Orthop, 2017, 88(1): 10-17.
9.	Kanawade V, Dorr LD, Wan Z. Predictability of acetabular component angular change with postural shift from standing to sitting position. J Bone Joint Surg (Am), 2014, 96(12): 978-986.
10.	Maratt JD, Esposito CI, McLawhorn AS, et al. Pelvic tilt in patients undergoing total hip arthroplasty: when does it matter? J Arthroplasty, 2015, 30(3): 387-391.
11.	Tanabe H, Homma Y, Yanagisawa N, et al. Validation of a preoperative formula to estimate postoperative pelvic sagittal alignment and mobility before performing total hip arthroplasty for patients with hip osteoarthritis. Arthroplasty, 2023, 5(1): 13. doi: 10.1186/s42836-023-00171-w.
12.	伍海昭, 王守立, 陳忠義, 等. 伴腰椎退變性后凸畸形的人工全髖關節置換安放髖臼假體前傾角的策略. 中國骨傷, 2020, 33(11): 1006-1011.
13.	Rutherford M, Connor JD, Gill HS, et al. Operative and radio graphic acetabular component orientation in total hip replace ment: Influence of pelvic orientation and surgical positioning technique. Med Eng Phys, 2019, 64: 7-14.
14.	左云周, 熊昌軍, 甘學文, 等. 改良髖臼前傾角及外展角校驗系統在不同入路全髖關節置換術中的應用. 實用骨科雜志, 2023, 29(4): 310-314.
15.	于德家, 李樹鋒, 閆新峰, 等. 髖臼橫韌帶可作為臼杯前傾角安放的參考. 中華關節外科雜志(電子版), 2020, 14(6): 703-708.
16.	曹林虎, 譚倫, 林旭, 等. 非骨水泥人工全髖關節置換術中髖臼骨缺損重建方式選擇及對臼杯位置影響的研究. 中國修復重建外科雜志, 2015, 29(6): 693-699.
17.	張文輝, 許杰, 李登, 等. 穿桌側位片及骨盆正位片測量髖臼杯前傾角的對比. 中華關節外科雜志(電子版), 2021, 15(2): 151-156.
18.	李騰飛, 王業華, 王紹龍. 腰椎僵直對全髖關節置換術患者姿勢性骨盆活動度的影響. 實用骨科雜志, 2022, 28(2): 109-113.
19.	Haffer H, Wang Z, Hu Z, et al. Does obesity affect acetabular cup position, spinopelvic function and sagittal spinal alignment? A prospective investigation with standing and sitting assessment of primary hip arthroplasty patients. J Orthop Surg Res, 2021, 16(1): 640. doi: 10.1186/s13018-021-02716-8.
20.	郭卓濤, 張凱, 查國春, 等. 腰椎融合對全髖關節置換后中期療效影響的匹配對照試驗. 中國組織工程研究, 2023, 27(36): 5801-5805.
21.	Sing DC, Barry JJ, Aguilar TU, et al. Prior lumbar spinal arthrodesis increases risk of prosthetic-related complication in total hip arthroplasty. J Arthroplasty, 2016, 31(9 Suppl): 227-232.
22.	Buckland AJ, Puvanesarajah V, Vigdorchik J, et al. Dislocation of a primary total hip arthroplasty is more common in patients with a lumbar spinal fusion. Bone Joint J, 2017, 99-B(5): 585-591.
23.	Gausden EB, Parhar HS, Popper JE, et al. Risk factors for early dislocation following primary elective total hip arthroplasty. J Arthroplasty, 2018, 33(5): 1567-1571.
24.	Innmann MM, Weishorn J, Beaule PE, et al. Pathologic spinopelvic balance in patients with hip osteoarthritis: Preoperative screening and therapeutic implications. Orthopade, 2020, 49(10): 860-869.
25.	王亞超, 黃健. 腰椎融合后全髖關節置換患者假體脫位與腰椎骨盆矢狀面參數的關系. 中國組織工程研究, 2021, 25(30): 4870-4876.
26.	Wan Z, Malik A, Jaramaz B, et al. Imaging and navigation measurement of acetabular component position in THA. Clin Orthop Relat Res, 2009, 467(1): 32-42.
27.	Heckmann N, McKnight B, Stefl M, et al. Late dislocation following total hip arthroplasty: spinopelvic imbalance as a causative factor. J Bone Joint Surg (Am), 2018, 100(21): 1845-1853.
28.	Luthringer TA, Vigdorchik JM. A preoperative workup of a “hip-spine” total hip arthroplasty patient: a simplified approach to a complex problem. J Arthroplasty, 2019, 34(7S): S57-S70.
29.	Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg (Br), 1993, 75(2): 228-232.

1. 董佩龍, 唐曉波, 王健, 等. 兩種入路全髖關節置換術治療老年股骨頸骨折的療效比較. 臨床骨科雜志, 2022, 25(4): 477-481.
2. 梁慶晨, 孫鳳龍, 王宏慶, 等. 磁導航脊柱內鏡下腰椎融合術治療單節段腰椎退行性疾病的療效觀察. 中國脊柱脊髓雜志, 2023, 33(8): 707-714, 723.
3. Miyagi M, Fukushima K, Inoue G, et al. Hip-spine syndrome: cross-sectional-study of spinal alignment in patients with coxalgia. Hip Int, 2019, 29(1): 21-25.
4. Haffer H, Wang Z, Hu Z, et al. Effect of coronal and sagittal spinal malalignment on spinopelvic mobility in patients undergoing total hip replacement: a prospective observational study. Clin Spine Surg, 2022, 35(6): E510-E519.
5. Lewinnek GE, Lewis JL, Tarr R, et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg (Am), 1978, 60(2): 217-220.
6. Grammatopoulos G, Falsetto A, Sanders E, et al. Integrating the combined sagittal index reduces the risk of dislocation following total hip replacement. J Bone Joint Surg (Am), 2022, 104(5): 397-411.
7. Tezuka T, Heckmann ND, Bodner RJ, et al. Functional safe zone is superior to the lewinnek safe zone for total hip arthroplasty: why the lewinnek safe zone is not always predictive of stability. J Arthroplasty, 2019, 34(1): 3-8.
8. Seagrave KG, Troelsen A, Malchau H, et al. Acetabular cup position and risk of dislocation in primary total hip arthroplasty. Acta Orthop, 2017, 88(1): 10-17.
9. Kanawade V, Dorr LD, Wan Z. Predictability of acetabular component angular change with postural shift from standing to sitting position. J Bone Joint Surg (Am), 2014, 96(12): 978-986.
10. Maratt JD, Esposito CI, McLawhorn AS, et al. Pelvic tilt in patients undergoing total hip arthroplasty: when does it matter? J Arthroplasty, 2015, 30(3): 387-391.
11. Tanabe H, Homma Y, Yanagisawa N, et al. Validation of a preoperative formula to estimate postoperative pelvic sagittal alignment and mobility before performing total hip arthroplasty for patients with hip osteoarthritis. Arthroplasty, 2023, 5(1): 13. doi: 10.1186/s42836-023-00171-w.
12. 伍海昭, 王守立, 陳忠義, 等. 伴腰椎退變性后凸畸形的人工全髖關節置換安放髖臼假體前傾角的策略. 中國骨傷, 2020, 33(11): 1006-1011.
13. Rutherford M, Connor JD, Gill HS, et al. Operative and radio graphic acetabular component orientation in total hip replace ment: Influence of pelvic orientation and surgical positioning technique. Med Eng Phys, 2019, 64: 7-14.
14. 左云周, 熊昌軍, 甘學文, 等. 改良髖臼前傾角及外展角校驗系統在不同入路全髖關節置換術中的應用. 實用骨科雜志, 2023, 29(4): 310-314.
15. 于德家, 李樹鋒, 閆新峰, 等. 髖臼橫韌帶可作為臼杯前傾角安放的參考. 中華關節外科雜志(電子版), 2020, 14(6): 703-708.
16. 曹林虎, 譚倫, 林旭, 等. 非骨水泥人工全髖關節置換術中髖臼骨缺損重建方式選擇及對臼杯位置影響的研究. 中國修復重建外科雜志, 2015, 29(6): 693-699.
17. 張文輝, 許杰, 李登, 等. 穿桌側位片及骨盆正位片測量髖臼杯前傾角的對比. 中華關節外科雜志(電子版), 2021, 15(2): 151-156.
18. 李騰飛, 王業華, 王紹龍. 腰椎僵直對全髖關節置換術患者姿勢性骨盆活動度的影響. 實用骨科雜志, 2022, 28(2): 109-113.
19. Haffer H, Wang Z, Hu Z, et al. Does obesity affect acetabular cup position, spinopelvic function and sagittal spinal alignment? A prospective investigation with standing and sitting assessment of primary hip arthroplasty patients. J Orthop Surg Res, 2021, 16(1): 640. doi: 10.1186/s13018-021-02716-8.
20. 郭卓濤, 張凱, 查國春, 等. 腰椎融合對全髖關節置換后中期療效影響的匹配對照試驗. 中國組織工程研究, 2023, 27(36): 5801-5805.
21. Sing DC, Barry JJ, Aguilar TU, et al. Prior lumbar spinal arthrodesis increases risk of prosthetic-related complication in total hip arthroplasty. J Arthroplasty, 2016, 31(9 Suppl): 227-232.
22. Buckland AJ, Puvanesarajah V, Vigdorchik J, et al. Dislocation of a primary total hip arthroplasty is more common in patients with a lumbar spinal fusion. Bone Joint J, 2017, 99-B(5): 585-591.
23. Gausden EB, Parhar HS, Popper JE, et al. Risk factors for early dislocation following primary elective total hip arthroplasty. J Arthroplasty, 2018, 33(5): 1567-1571.
24. Innmann MM, Weishorn J, Beaule PE, et al. Pathologic spinopelvic balance in patients with hip osteoarthritis: Preoperative screening and therapeutic implications. Orthopade, 2020, 49(10): 860-869.
25. 王亞超, 黃健. 腰椎融合后全髖關節置換患者假體脫位與腰椎骨盆矢狀面參數的關系. 中國組織工程研究, 2021, 25(30): 4870-4876.
26. Wan Z, Malik A, Jaramaz B, et al. Imaging and navigation measurement of acetabular component position in THA. Clin Orthop Relat Res, 2009, 467(1): 32-42.
27. Heckmann N, McKnight B, Stefl M, et al. Late dislocation following total hip arthroplasty: spinopelvic imbalance as a causative factor. J Bone Joint Surg (Am), 2018, 100(21): 1845-1853.
28. Luthringer TA, Vigdorchik JM. A preoperative workup of a “hip-spine” total hip arthroplasty patient: a simplified approach to a complex problem. J Arthroplasty, 2019, 34(7S): S57-S70.
29. Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg (Br), 1993, 75(2): 228-232.

Chinese Journal of Reparative and Reconstructive Surgery

Application of modified acetabular anteversion and inclination angles test system in patients undergoing total hip arthroplasty after lumbar fusion

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content