退行性脊柱侧凸和旋转骨盆参数对髋关节半关节置换术脱位的影响。

Sevan Sıvacıoğlu, Mustafa Caglar Kır, Ali Çağrı Tekin, Mehmet Selçuk Saygılı, Mehmet Kurşad Bayraktar, Ali Kafadar, Gülay Kır, Hülya Kurtul Yıldız, Esra Akdas Tekin, Sertac Tatar
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引用次数: 0

摘要

背景:脊柱退变可能会影响骨盆参数和髋关节活动度。本研究旨在评估退行性脊柱侧弯和脊柱骨盆参数对髋关节半关节成形术后脱位的影响:对二十年间因髋关节囊内骨折接受半关节成形术的患者进行了回顾性分析。对人口统计学数据、脱位发生率、退行性脊柱侧凸(DS)状态、半关节成形术类型、髋关节手术干预、股骨头大小、骨水泥使用、美国麻醉医师协会(ASA)评分、体重指数(BMI)和院内死亡率进行了评估。测量并分析了Cobb角(CA)、骨盆入射角(PI)、骶骨斜度(SS)、骨盆倾斜度(PT)、腰椎前凸(LL)和胸椎后凸角(TK):共评估了 284 名患者,平均年龄为 79.07 (±8.21) 岁。半关节成形术脱位发生率为13%(n=37)。25.4%的病例发现了退行性脊柱侧凸,且退行性脊柱侧凸患者的发病率明显更高(P=0.001)。高龄、较高的体重指数(BMI)、较高的ASA评分、单极性和无骨水泥半关节成形术、较小的股骨头尺寸以及后入路都会显著增加脱位频率(分别为P=0.004、P=0.001、P=0.03、P=0.001、P=0.001和P=0.026)。脱位和退行性脊柱侧凸患者的平均PI、SS、PT、LL和TK角度显著减小(脱位:分别为P=0.001、P=0.001、P=0.001、P=0.003、P=0.048;退行性脊柱侧凸:分别为P=0.001、P=0.001、P=0.001、P=0.001、P=0.001):结论:退行性脊柱侧凸和骨盆入径低、骶骨斜度低、骨盆倾斜、胸椎后凸和腰椎前凸角度低可能会增加半关节成形术脱位的频率。后入路和小股骨头也可能会增加后脱位的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of degenerative scoliosis and spinopelvic parameters on dislocation of hip hemiarthroplasty.

Background: Degeneration of the spine may affect pelvic parameters and hip mobility. This study aimed to evaluate the effects of degenerative scoliosis and spinopelvic parameters on hip hemiarthroplasty dislocations.

Methods: A retrospective analysis was conducted on patients who underwent hemiarthroplasty for intracapsular hip fracture over a twenty-year period. Demographic data, dislocation incidence, degenerative scoliosis (DS) status, type of hemiarthroplasty, surgical intervention to the hip, femoral head size, cement use, American Society of Anesthesiologists (ASA) score, body mass index (BMI), and in-hospital mortality were evaluated. The Cobb angle (CA), pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), and thoracic kyphosis (TK) angles were measured and analyzed.

Results: A total of 284 patients were evaluated, with a mean age of 79.07 (±8.21) years. The frequency of hemiarthroplasty dislocation was 13% (n=37). Degenerative scoliosis was detected in 25.4% of the cases and was significantly more common in patients with degenerative scoliosis (p=0.001). Advanced age, higher BMI, higher ASA score, unipolar and cementless hemiarthroplasty, smaller femoral head size, and the posterior approach significantly increased dislocation frequency (p=0.004, p=0.001, p=0.03, p=0.001, p=0.001, and p=0.026, respectively). The mean PI, SS, PT, LL, and TK angles were significantly reduced in patients with dislocation and degenerative scoliosis (dislocation: p=0.001, p=0.001, p=0.001, p=0.003, p=0.048; degenerative scoliosis: p=0.001, p=0.001, p=0.001, p=0.001, p=0.001; respectively).

Conclusion: The presence of degenerative scoliosis and low pelvic incidence, sacral slope, pelvic tilt, thoracic kyphosis, and lumbar lordosis angles may increase the frequency of hemiarthroplasty dislocations. The posterior approach and small femoral head size may also elevate the risk of posterior dislocation.

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