Objective: To investigate the accuracy and effectiveness of acetabular cup placement in total hip arthroplasty (THA) after lumbar fusion applying of modified acetabular anteversion and inclination angles test system.
Methods: A clinical data of 45 patients undergoing THA for osteoarthritis between January 2018 and June 2023 was retrospectively analyzed. All patients had previously received lumbar fusion. The modified acetabular anteversion and inclination angle test system was used in 26 cases (observation group) and not used in 19 cases (control group) during THA. There was no significant difference in baseline data such as gender, age, body mass index, operative side, number of lumbar fusion segments, and preoperative Harris score between the two groups ( P>0.05). The position of acetabular prosthesis, hip function (Harris score), and incidence of complications were compared between the two groups.
Results: In the observation group, all acetabular cups were in the safe zone (anteversion angle, 25°-30°) during operation, and 1 acetabular cup (3.85%) was not in the safe zone after operation. In the control group, 9 acetabular cups (47.37%) were not in the safe zone. The postoperative difference between the two groups was significant ( P<0.05). There was no significant difference between intra- and post-operative acetabular inclination angles in the observation group ( P>0.05), and the postoperative acetabular inclination angle was significantly smaller in the observation group than in the control group ( P<0.05). All incisions healed by first intention and no infection occurred. All patients were followed up 6 months. There was no significant difference in Harris score between the two groups at different time point ( P>0.05), and there were significant differences between different time points in the two groups ( P<0.05). No joint dislocation occurred in the observation group during follow-up, while dislocation occurred in 2 cases and femoral impingement syndrome occurred in 1 case of the control group. There was no significant difference in the incidence of complications between the two groups ( P>0.05).
Conclusion: For THA patients with lumbar fusion, the ideal placement angle of the acetabular cup can be obtained by using the modified acetabular anteversion and inclination angles test system during operation.
目的: 探讨采用改良髋臼前倾角及外展角校验系统辅助腰椎融合患者人工全髋关节置换术（total hip arthroplasty，THA）中髋臼杯放置的准确性及疗效。.
方法: 回顾分析2018年1月—2023年6月45例因骨关节炎行THA患者的临床资料，患者既往均接受腰椎融合术。THA术中26例采用改良髋臼前倾角及外展角校验系统（观察组），19例未采用该系统（对照组）。两组患者性别、年龄、身体质量指数、手术侧别、腰椎融合节段数量以及术前Harris评分等基线资料比较，差异均无统计学意义（ P>0.05）。比较两组患者术后髋臼假体位置、髋关节功能（Harris评分）以及并发症发生情况。.
结果: 观察组术中髋臼杯均在安全区（前倾角25°～30°），术后1例（3.85%）位于安全区外；对照组术后9例（47.37%）位于安全区外；两组术后比较差异有统计学意义（ P<0.05）。观察组术中及术后髋臼外展角差异无统计学意义（ P>0.05），观察组术后髋臼外展角小于对照组（ P<0.05）。术后切口均Ⅰ期愈合，均未发生感染。两组患者均获随访6个月。Harris评分各时间点组间比较差异均无统计学意义（ P>0.05）；组内各时间点间比较差异有统计学意义（ P<0.05）。观察组随访期间无并发症发生；对照组发生2例关节脱位、1例股骨撞击综合征；但两组并发症发生率差异无统计学意义（ P>0.05）。.
结论: 腰椎融合患者THA术中可应用改良髋臼前倾角及外展角校验系统获得理想髋臼杯植入角度。.
Keywords: Total hip arthroplasty; acetabular prosthesis; anteversion angle; inclination angle; lumbar fusion.