背景:先天性髋臼发育不良患者与髋关节翻修患者常存在髋臼上方骨量缺损,使得髋臼侧的处理在髋关节置换术中更为复杂困难.有学者建议髋臼高位放置确保适当的宿主骨接触的同时简化手术,而其作为影响生物力学的手术方式引起很多人的担忧,甚至临床疗效遭到质疑.目的:综述近年国内外髋臼高位放置技术在人工髋关节置换术中的研究进展.方法:第一作者应用计算机检索至2016年12月PubMed数据库、中国期刊全文数据库的相关文章,以"proximal placement,superior placement,high placement,high hip center,elevated hip center,total hip arthroplasty,revision total hip arthroplasty,dysplasia of developmental hip"为英文检索词,"高旋转中心,髋臼高位技术,髋臼高位放置,全髋关节置换术,髋关节翻修术,先天性髋关节发育不良"为中文检索词.共检索到67篇相关文献,45篇文献符合纳入标准.结果与结论:①对于髋关节置换手术中面临的髋臼骨缺损问题,髋臼高位放置是一种选择,尤其对复杂骨缺损患者可以简化手术;②尽管违背了恢复解剖旋转中心的原则,通过重建位置的调整、摩擦界面的改善、假体的适当选择,以及手术技术和理念的进步,髋臼高位技术可以在与宿主骨直接接触的范围和强度的基础上获得良好的初始稳定性,进而实现令人满意的长期生物固定效果,同时不会影响髋关节的生物力学;③目前中英文文献中髋臼高位放置的定义和名称较为混乱,有待对此进一步规范完善.%BACKGROUND: Bone defects are widely seen in patients with development dysplasia of hip or revision, thus resulting in a difficulty in acetabular treatment. High placement technique has been suggested to ensure the appropriate bone-prosthesis contact and simplify the surgery. Because biomechanics is involved, it has aroused many concerns,even its curative efficacy.OBJECTIVE: To summarize the research and progress of high placement technique applied in total hip arthroplasty (THA).METHODS: A computer-based online research was conducted for articles published until December 2016 in PubMed and CNKI databases using the keywords of "proximal placement, superior placement, high placement, high hip center,elevated hip center, total hip arthroplasty, revision total hip arthroplasty, dysplasia of developmental hip" in English and Chinese, respectively. Totally 67 literatures were retrieved, and finally 45 eligible articles were enrolled in accordance with the inclusion criteria.RESULTS AND CONCLUSION: (1) High placement technique is feasible for acetabular bone defects in THA, especially can simplify THA with complicated conditions. (2) Seemingly it goes against the principle of restoring anatomic hip center,but THA with high placement can obtain initial stability based on enough bone contact through adjusting the reconstruction position properly, interface improvement, appropriate prosthesis, as well as developed operations and conception, meanwhile, exposes no effect on biomechanics of hip. (3) Notably, the definition and term of high placement are chaotic in Chinese and English literatures, which need to be standardized further.
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