The Guidance Significance Of Combined Anteversion On The Rotation Center In Hip Revision

Objective: With into an aging society,the total hip replacement(THA)increased year by year,the number of hip revision procedures also showed a trend of increase year by year.Effective reconstruction to restore function,reducing the complications of the hip is the ultimate goal of hip revision procedures.In primary total hip replacement,we can use acetabulum transverse ligament,acetabulum rim s anatomical symbol aided positioning acetabulum cup abducent angles and former angle,so it is easier to obtain satisfactory prosthesis position and angle.For the hip revision cases,there are often the destruction of the anatomical symbol,the acetabulum and femur proximal structural abnormalities,which makes the difficulty of hip revision procedures.Due to many factors,the prosthesis is difficult to achieve the ideal safe zone.It is difficult to obtain the normal rotation center.Combined anteversion technique was used for total hip arthroplasty,according to the technique,hip prosthesis can be installed in the ideal position and satisfied direction,but no application in hip revision in the report.This is a retrospective study on combined anteversion in rotation center in hip revision surgery,preventing postoperative dislocation,loosening and impact effect.Methods: This retrospective study was from 2010,11 to 2016,11.We measured the combined anteversion before technology successfully 15 hip revision surgery in 15 cases,aged 38-72,an average of 61.40 ± 8.45 years old.The 13 hip of 15 cases was men,age 38-72,mean age 60.54 ± 8.78 years old;Two women in 2 hips,age 66 years old and 68 years old,average age 67.All cases by adopting the technology of combined anteversion technique,according to former femoral angle adjustment before the acetabulum angle and abducent angles.Postoperative CT examination of the acetabulum prosthesis abducent angles,the anteversion and combined anteversion.Results: All patients were followed up,follow-up time 1-5 years,3 years on average.Postoperative pelvic CT examination of acetabulum abducent angles as follows: 27.27 ± 7.81 °(20-35 °),the anteversion is 16.93±3.63 °(13-21 °),the combined anteversion is 42.87±7.08 °(35 to 50 °).Surgical group vertical height is 3.89 ± 0.42 cm,offset is 4.10 ± 0.28 cm.On the side or both side vertical height is 4.10±0.44 cm,and offset is 3.90± 0.36 cm.For preoperative,Harris score is 41.07±4.65 points(37-45 points).For postoperative Harris score is 88.33 ±2.99 points(85-91 points).The hip joint function score improved significantly.Among them 2 cases,the combined anteversion is beyond safety,but patients with no hip pain,feel satisfied with the surgery.All patients were no dislocation,prosthesis loosening and infection occurred.Conclusion: CA measurement has a guiding significance on hip revision surgery.Good acetabulum prosthesis for the acetabulum and femoral prosthesis implantation angle is important significance for the stability,reducing wear and preventing dislocation.But because of limited number of cases in the study,the results have some limitations,we need to increase the number of cases and to further improve its clinical guidance.