Study On The Angle Of Acetabular Transverse Ligament In Total Hip Arthroplasty

[Objective]To evaluate the anteversion and abduction angle of acetabulum after THA,and to follow up the dislocation of acetabulum and Harris score.To clarify the reference value of Tal in THA.[Methods] From 2018 to 2019,60 patients with unilateral THA were admitted to the First Affiliated Hospital of Hebei North College.The 60 patients were randomly divided into experimental group and control group.In the experimental group,the acetabular prosthesis was located with the help of the transverse ligament of acetabulum on the basis of the bare-handed visual method,while in the control group,the legal acetabular prosthesis was only measured with the bare-handed visual method.Surgical methods: All patients were positioned in the vertical lateral position(the affected hip joint is on the upper side)and the beds were in the horizontal position(the beds were parallel to the ground).All of the acetabular prostheses were made and supplied by the same manufacturer.All of the acetabular prostheses were cementless,that is,the prostheses were made of metal-pair polyethylene,and all of the operations were performed by the same group of experienced doctors.In the experimental group,the acetabular ligaments were fully exposed.In the experimental group,the anterior angle of the acetabular prosthesis was located with the help of the transverse ligament of the acetabulum,even if the lower edge of the file opening was parallel to the transverse ligament of the acetabulum.In the control group,the position and direction of the acetabular file were determined by visual measurement.The position and direction of the acetabular file were determined according to the forward and abduction angles of the acetabular file,and the position and direction of the acetabular file were approximately 15 ° forward from the patient’s longitudinal axis and45 ° abduction from the bed.All patients had appropriate acetabular prostheses.Postoperative treatment: On the third day after operation,all the patients’ anterior angle of acetabular prosthesis was measured by X-ray,and the dislocation of acetabular prosthesis was observed at the 6th month after operation.The function and pain of the patients’ side hip were evaluated and compared(Harris score at the 1st and 3rd month after operation).[results]All the cases were observed and the incisions were clinically healed by I phase.No dislocation of acetabular prosthesis occurred in the experimental group within 6 months,and 2 patients in the control group within 6 months.There was no significant difference between the experimental group and the control group(P =0.472> 0.05).1.After operation,the anteversion angle of acetabular prosthesis of the experimental group was(16.14 ± 3.92 °),and P = 0.12 > 0.05 compared with the best angle defined by Lewinnek(15 ± 10 °),but the difference was not statistically significant;the abduction angle was(44.40 ± 2.63 °),and P =0.218 > 0.05 compared with the best angle(45 ± 10 °).Compared with the best angle,there was no significant difference(P = 0.31 > 0.05).But the abduction angle was(43.65 ± 7.57 °),and there was no significant difference(P = 0.18 > 0.05).2.Compared with the control group,the anteversion and abduction angles of the experimental group were not significant(anteversion angle P =0.830,abduction angle P = 0.613,both > 0.05).3.The Harris score of hip was significantly higher in both groups after1 and 3 months(Experimental group P = 0.229,control group P = 0.261 P< 0.001).There was no significant difference between experimental group and control group(P = 0.229 in experimental group,P = 0.261 in control group,P values of both groups were more than 0.05).The Harris score of the experimental group was higher than that of the control group at 1 and 3months after operation,but there was no statistical significance(1 month=0.664,3 month = 0.229,all > 0.05).After operation,the patients were satisfied with the perception of the operation results.The patients in the experimental group had a Harris score ≥ 90 or more in 3 months postoperatively,22 cases(73.33%)were in the experimental group,while 20cases(66.67%)were in the control group.4.The anteversion angle and abduction angle of acetabular prosthesis were located in the safety zone in the experimental group and 6 patients in the control group.[Conclusion] Using TAL as a reference,it is of great significance to determine the angle of acetabular prosthesis in THA,which can be used to locate acetabular prosthesis accurately.It can effectively avoid the dislocation and abrasion of acetabular prosthesis after THA and obtain the satisfaction of most patients who experience the effect of acetabular prosthesis.