Change in cup orientation from supine to standing posture: a prospective cohort study of 419 total hip arthroplasties.

IF 2.5 2区 医学 Q1 ORTHOPEDICS
Camille Vorimore, Jeroen C F Verhaegen, Moritz Innmann, A Paul Monk, Christopher Ling, George Grammatopoulos
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引用次数: 0

Abstract

Background and purpose: Arthroplasty surgeons traditionally assess cup orientation after total hip arthroplasty (THA) on supine radiographs. Contemporary hip-spine analyses provide information on standing, functional cup orientation. This study aims to (i) characterize cup orientations when supine and standing; (ii) determine orientation differences between postures; and (iii) identify factors associated with magnitude of orientation differences.

Methods: This is a 2-center, multi-surgeon, prospective, consecutive cohort study. 419 primary THAs were included (57% women; mean age: 64 years, standard deviation [SD] 11). All patients underwent supine and standing antero-posterior pelvic and lateral spinopelvic radiographs. Cup orientation and spinopelvic parameters were measured. Target cup orientation was defined as inclination/anteversion of 40°/20° ± 10°. A change in orientation (Δinclination/Δanteversion) between postures > 5° was defined as clinically significant. Variability was defined as 2 x SD.

Results: Inclination increased from 40° (supine) to 42° (standing) corresponding to a Δinclination of 2° (95% confidence interval [CI] 2-3). Anteversion increased from 25° (supine) to 30° (standing) corresponding to a Δanteversion of 5° (CI 5-6). When supine, 69% (CI 65-74) of THAs were within target, but only 44% (CI 39-49) were within target when standing, resulting in a further 26% (CI 21-30) being out of target when standing. From supine to standing, a clinically significant change in anteversion (> 5°) was seen in 47% (CI 42-52) of cases. Δanteversion was higher in women than in men (6°, CI 5-7 vs 5°, CI 4-5) corresponding to a difference of 1° (CI 1-2), which was dependent on tilt change, standing cup anteversion, age, and standing pelvic tilt.

Conclusion: Cup inclination and version increase upon standing but significant variability exists due to patient factors.

从仰卧姿态到站立姿态髋臼杯方向的变化:对 419 例全髋关节置换术进行的前瞻性队列研究。
背景和目的:传统上,关节置换外科医生会在全髋关节置换术(THA)后通过仰卧位X光片评估髋臼杯方向。当代的髋关节脊柱分析提供了站立、功能性髋臼杯方向的信息。本研究旨在:(i) 描述仰卧和站立时的髋臼杯方向;(ii) 确定不同姿势下的方向差异;(iii) 确定与方向差异大小相关的因素:这是一项由两个中心、多名外科医生参与的前瞻性连续队列研究。共纳入 419 例初次 THAs(57% 为女性;平均年龄:64 岁,标准差 [SD] 11)。所有患者均接受了仰卧位和站立位前正位骨盆和侧位脊柱骨盆X光片检查。对髋臼杯方向和脊柱骨盆参数进行了测量。目标髋臼杯方位定义为倾斜/前倾 40°/20° ± 10°。不同姿势之间的方向变化(Δ倾角/Δ后倾角)> 5°被定义为具有临床意义。变异性定义为 2 x SD:结果:倾角从 40°(仰卧位)增加到 42°(站立位),Δ倾角为 2°(95% 置信区间 [CI] 2-3)。前倾角从 25°(仰卧位)增加到 30°(站立位),对应的 Δ前倾角为 5° (CI 5-6)。仰卧时,69%(CI 65-74)的 THAs 在目标范围内,但站立时只有 44%(CI 39-49)在目标范围内,导致站立时又有 26%(CI 21-30)超出目标范围。从仰卧到站立,47%(CI 42-52)的病例出现了临床上显著的内翻变化(> 5°)。女性的Δ前倾角高于男性(6°,CI 5-7 vs 5°,CI 4-5),相差1°(CI 1-2),这与倾斜度变化、站立时的髋臼杯前倾角、年龄和站立时的骨盆倾斜度有关:结论:站立时髋臼杯的倾斜度和倾斜度都会增加,但由于患者的因素而存在很大的差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta Orthopaedica
Acta Orthopaedica 医学-整形外科
CiteScore
6.40
自引率
8.10%
发文量
105
审稿时长
4-8 weeks
期刊介绍: Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.
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