Functional assessment of component positioning in patients with groin pain after total hip arthroplasty as a tool to guide management.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-05-01 Epub Date: 2023-10-20 DOI:10.1177/11207000231205843
Georgina C Waters, Christopher Jones, Peter D'Alessandro, Piers Yates
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引用次数: 0

Abstract

Background: Persisting groin pain post total hip arthroplasty (THA) is a common and complex issue that can be difficult to diagnose and manage. Acetabular component positioning is often implicated.

Aims and methods: We used a previously well described and validated functional positioning protocol to determine if functional acetabular malpositioning was a factor in groin pain post THA and hence to determine if acetabular revision would be indicated. We compared patient-specific functional acetabular positioning to traditional CT evaluation of cup position and assessment of anterior cup overhang.

Results: 39 patients with groin pain post-THA were investigated. Functional acetabular malpositioning was diagnosed in 31% (12/39). Revision THA was performed in those 12 patients, resulting in resolution of functional malpositioning (100%), with an overall accuracy of 5.6° (range 1-12), and resolution of groin pain in 67% (8/12). 33% (4/12) of the revised implants had functional positioning located outside the traditional "40/20 zone". Comparison with CT indicated that 40% (4/10) of implants with anterior overhang were well positioned, however only 50% (6/12) of functionally malpositioned implants had CT evidence of anterior cup prominence. Of the 8/12 revision patients who had resolution of their groin pain, only 1 had cup prominence.

Conclusions: This study suggests that the utilisation of a patient specific functional positioning algorithm in the analysis of persistent groin pain following THA can assist in identifying the underlying cause of pain and help to guide treatment. For a functionally malpositioned acetabulum, revision surgery offers a potential resolution of groin pain.

全髋关节置换术后腹股沟疼痛患者组件定位的功能评估作为指导管理的工具。
背景:全髋关节置换术后腹股沟持续疼痛是一个常见而复杂的问题,很难诊断和治疗。髋臼组件的定位经常受到牵连。目的和方法:我们使用先前描述和验证的功能定位方案来确定功能性髋臼错位是否是THA后腹股沟疼痛的一个因素,从而确定是否需要髋臼翻修。我们比较了患者特定功能性髋臼定位与传统CT评估髋臼杯位置和评估髋臼杯前悬突。结果:对39例THA术后腹股沟疼痛患者进行了调查。31%(12/39)的患者被诊断为功能性髋臼错位。在这12名患者中进行了翻修THA,功能性错位得到了解决(100%),总体准确度为5.6°(范围1-12),腹股沟疼痛得到了解决67%(8/12)。33%(4/12)的改良植入物的功能定位位于传统的“40/20区”之外。与CT的比较表明,40%(4/10)的前悬植入物定位良好,但只有50%(6/12)的功能性错位植入物具有前杯突出的CT证据。在8/12例腹股沟疼痛得到缓解的翻修患者中,只有1例出现杯状突起。结论:本研究表明,在THA后持续性腹股沟疼痛的分析中,使用患者特异性功能定位算法可以帮助确定疼痛的根本原因,并有助于指导治疗。对于功能错位的髋臼,翻修手术可以潜在地解决腹股沟疼痛。
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
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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