The purpose of this study was to investigate whether postoperative combined anteversion (CA) can be kept within the safe zone while using cementless total hip arthroplasty (THA) using the operative technique which prepares the socket first for developmental dysplasia of the hip (DDH), by estimating the anteversion of the metaphyseal fit stem using preoperative three-dimensional (3D) computerized planning and by adjusting the anteversion of the socket using a navigation system that considers CA. Our subjects were 65 patients (65 hips) that had undergone cementless THA for DDH that could be observed for 1 year or more. Clinical assessments were made using the Japanese Orthopaedic Association’s (JOA) hip score. For a radiological evaluation, we investigated 3D-planned stem versions, postoperative stem versions, preoperative and postoperative CA, and the relationship between CA and dislocation tendencies with temporary intraoperative reductions. JOA hip scores improved from 52.3 ± 11.4 points to 88.9 ± 8.6 points. CT evaluations revealed that 3D-planned stem versions were strongly correlated with postoperative stem versions (r = 0.80; p < 0.01). Preoperative CA was 50.5° ± 7.2°, and postoperative CA was 41.3° ± 8.6°. Postoperative CA was kept within the safe zone in 61 hips. No intraoperative dislocation tendencies were observed in any hips. By estimating the anteversion of the cementless metaphyseal fit stem using 3D planning preoperatively and adjusting the angle of anteversion of the socket using a navigation system that considers CA intraoperatively, postoperative CA can very frequently be kept within the safe zone, even with cementless THA using the operative technique which prepares the socket first for DDH.
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机译:这项研究的目的是研究使用非骨水泥性全髋关节置换术(THA)的手术技术是否可以将术后联合前倾角(CA)保持在安全区域内,该技术首先为髋部发育不良(DDH)做准备,通过使用术前三维(3D)计算机化计划来评估干phy端适合茎的前倾,并使用考虑了CA的导航系统来调整承窝的前倾。我们的受试者为65例患者(65髋),他们接受了DDH的非骨水泥THA治疗,可观察1年或更长时间。临床评估是使用日本骨科协会(JOA)的髋关节评分进行的。为了进行放射学评估,我们调查了3D计划的茎干版本,术后茎干版本,术前和术后CA,以及CA与脱位倾向与术中临时复位之间的关系。 JOA髋关节评分从52.3±11.4分提高到88.9±8.6分。 CT评估显示3D计划的茎干版本与术后茎干版本密切相关(r = 0.80; p <0.01)。术前CA为50.5°±7.2°,术后CA为41.3°±8.6°。术后CA保持在61髋的安全区内。在任何髋部均未观察到术中脱位倾向。通过术前使用3D规划估计非骨水泥型干phy端配合柄的前倾角,并在考虑术中CA的导航系统中调整承窝的前倾角,即使使用非骨水泥型THA进行手术,CA仍可非常频繁地保持在安全区内。首先为DDH准备插座的操作技术。
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