[脊柱骨盆活动度评估;其在预防全髋关节置换脱位中的重要性]。

Acta ortopedica mexicana Pub Date : 2024-01-01
F Gómez-García
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引用次数: 0

摘要

最近,人们认识到腰骶部脊柱的改变导致的矢状对齐和脊柱骨盆活动度的变化会影响髋关节置换的脱位。这一问题的最大困难在于:a)与该主题相关的文献均为英文撰写,术语混乱;b)对于应使用哪些参数来识别、测量和估计脱位发生的风险尚未达成共识;c)对脊柱疾病与假体脱位之间相互关系的基本概念理解不清;d)脊柱外科医生和髋关节外科医生追求不同的目标。这篇叙述性综述的目的是通过采用一种策略来回答一些问题,从而克服上述困难:髋关节脱位真的是一个问题吗?骨盆脊柱平衡的改变与假体脱位之间的相互关系是什么?如何定义矢状面平衡和腰骶部活动度,如何测量它们的变化?它们实现良好功能的代偿机制是什么,以及如何利用这些机制来正确定位髋臼?为了记录这篇综述,我们查阅了 PubMed、Scopus、SciELO 和 Google Scholar 等数据库,关键词包括脊柱、全髋关节置换术、髋关节脱位、脊柱-骨盆-髋关节置换术。作者选择了其认为最客观和/或与本主题研究最相关的文章。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Evaluation of spino-pelvic mobility; its importance in preventing total hip replacement dislocation].

Recently, it has been recognized that changes in sagittal alignment and spinopelvic mobility due to alterations of the lumbosacral spine can influence the dislocation of a hip replacement. The biggest difficulties for this problem are: a) the bibliography related to this topic has been written in English and there is confusion in its terminology; b) there is no consensus on what parameters should be used to identify, measure, and estimate the risks of dislocation occurring; c) the basic concepts that interrelate spinal disorders and prosthetic dislocation are not clearly understood; and d) spine and hip surgeons pursue different goals. The objective of this narrative review is to overcome the aforementioned difficulties by using a strategy to answer some questions: Is hip dislocation really a problem? What is the interrelationship between alterations in the pelvic spinal balance and the dislocation of a prosthesis? How is sagittal balance and lumbosacral mobility defined and how can their alterations be measured? What are their compensatory mechanisms to achieve a good functioning and how these mechanisms can be used to correctly orient the acetabulum? To document this review, we consulted the databases of PubMed, Scopus, SciELO and Google Scholar with the keywords: Spinopelvic, Total Hip Arthroplasty, Hip Dislocation, Spine-Pelvis-hip Arthroplasty. The articles that, in the author's opinion, were the most objective and/or relevant for the study of this topic were selected.

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