Joseph Kromka, William Zuke, Caroline Granger, John Clohisy, Robert Barrack
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Changes in pelvic tilt were compared from initial X-rays to final follow-up and between two subgroups based on age. Clinically meaningful changes in pelvic tilt and estimated acetabular position were calculated.</p><p><strong>Results: </strong>There were 200 patients included: 100 aged 45 to 50 years, and 100 aged 55 to 60 years. Their mean age was 52, 111 were men, and mean BMI was 29.67 (range, 18.79 to 49.31). Pelvic tilt change over the 10-year period was -9.87 degrees (Standard Deviation (SD) 10.22), P <0.001. This corresponds to an increase in acetabular inclination of 1.97 degrees and anteversion of 7.90 degrees. There was meaningful change in 62.5% of patients' posterior tilt with functional change in version or inclination of > 5 degrees. The subgroup of patients aged 45 to 50 had a larger change in pelvic tilt (-11.50 degrees, SD 9.04) than patients 55 to 60 (-8.25 degrees, SD 11.01), P = 0.024.</p><p><strong>Conclusions: </strong>We observed increases in posterior tilt in patients 10 years following THA or SRA, resulting in functionally increased acetabular anteversion and inclination. Larger increases in posterior tilt were seen in the younger group which has implications for initial cup placement in patients with normal spines.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The CCJR® Charles A. Engh, Sr, MD. 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The subgroup of patients aged 45 to 50 had a larger change in pelvic tilt (-11.50 degrees, SD 9.04) than patients 55 to 60 (-8.25 degrees, SD 11.01), P = 0.024.</p><p><strong>Conclusions: </strong>We observed increases in posterior tilt in patients 10 years following THA or SRA, resulting in functionally increased acetabular anteversion and inclination. 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引用次数: 0
摘要
背景：髋臼杯位置是全髋关节置换术（THA）和关节表面置换术（SRA）的基础。即使最初的杯子放置是适当的，随着时间的推移，脊柱-骨盆关系的变化也会改变髋臼的功能位置。这可能导致晚期并发症。本研究的目的是研究THA或SRA术后随访至少10年的患者骨盆倾斜和髋臼位置的变化。方法：回顾性分析来自一个学术实践的患者，他们接受了THA或SRA，随访至少10年。测量骨盆比例并转换为骨盆倾斜[1,2]。骨盆倾斜的变化从最初的x光片到最后的随访进行比较，并根据年龄在两个亚组之间进行比较。计算骨盆倾斜和髋臼位置的临床意义变化。结果：纳入200例患者：年龄45 ~ 50岁100例，年龄55 ~ 60岁100例。平均年龄52岁，男性111例，平均BMI为29.67（范围18.79 ~ 49.31）。10年间盆腔倾斜变化为-9.87度（标准差（SD） 10.22）， P = 5度。45 ~ 50岁患者的骨盆倾斜变化（-11.50度，SD 9.04）大于55 ~ 60岁患者（-8.25度，SD 11.01）， P = 0.024。结论：我们观察到THA或SRA术后10年患者后侧倾斜增加，导致髋臼前倾和倾斜功能增加。在较年轻的组中观察到较大的后倾角增加，这意味着在脊柱正常的患者中初始放置罩杯。
The CCJR® Charles A. Engh, Sr, MD. Excellence in Hip Research Award: Pelvic Tilt and Cup Position Change Significantly in Most Young Patients Ten Years After Hip Arthroplasty.
Background: Acetabular cup position is fundamental to total hip arthroplasty (THA) and surface replacement arthroplasty (SRA). Even if initial cup placement is adequate, changes in spino-pelvic relationships alter functional acetabular position over time. This can lead to late complications. The purpose of this study was to examine changes in pelvic tilt and acetabular position in patients with at least 10 years of follow-up after THA or SRA.
Methods: A retrospective review was conducted of patients from one academic practice who underwent THA or SRA and had at least 10 years of follow-up. Pelvic ratio was measured and converted to pelvic tilt [1, 2]. Changes in pelvic tilt were compared from initial X-rays to final follow-up and between two subgroups based on age. Clinically meaningful changes in pelvic tilt and estimated acetabular position were calculated.
Results: There were 200 patients included: 100 aged 45 to 50 years, and 100 aged 55 to 60 years. Their mean age was 52, 111 were men, and mean BMI was 29.67 (range, 18.79 to 49.31). Pelvic tilt change over the 10-year period was -9.87 degrees (Standard Deviation (SD) 10.22), P <0.001. This corresponds to an increase in acetabular inclination of 1.97 degrees and anteversion of 7.90 degrees. There was meaningful change in 62.5% of patients' posterior tilt with functional change in version or inclination of > 5 degrees. The subgroup of patients aged 45 to 50 had a larger change in pelvic tilt (-11.50 degrees, SD 9.04) than patients 55 to 60 (-8.25 degrees, SD 11.01), P = 0.024.
Conclusions: We observed increases in posterior tilt in patients 10 years following THA or SRA, resulting in functionally increased acetabular anteversion and inclination. Larger increases in posterior tilt were seen in the younger group which has implications for initial cup placement in patients with normal spines.
期刊介绍：
The Journal of Arthroplasty brings together the clinical and scientific foundations for joint replacement. This peer-reviewed journal publishes original research and manuscripts of the highest quality from all areas relating to joint replacement or the treatment of its complications, including those dealing with clinical series and experience, prosthetic design, biomechanics, biomaterials, metallurgy, biologic response to arthroplasty materials in vivo and in vitro.
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