| Objective:To investigate the effect of acetabular prosthesis placement on hip joint function after total hip arthroplasty(THA).Methods:The clinical data of 432 patients who underwent unilateral THA treatment at the Second Hospital of Shanxi Medical University from April 2015 to April 2018 were retrospectively analyzed.The position parameters of the acetabular prosthesis of the patient were measured by the image storage and transmission system PACS and SIEMENS imaging software of the Second Hospital of Shanxi Medical University.The position parameters of the acetabular prosthesis in this study included: acetabular abduction angle,acetabular anteversion angle,horizontal position of the femoral head rotation center,vertical position of the femoral head rotation center and femoral offset.The patients were followed up to evaluate the last modified Harris score and hip range of motion.The position parameters of each acetabular prosthesis were grouped separately,and the hip range of motion,modified Harris score and good rate of Harris score were compared between different groups.Results:The mean follow-up time was(23.1 ± 7.3)months.The average Harris score at the last follow-up was(90.6 ± 6.4)points and the good of Harris score rate was 89.8%.There was a statistically significant difference between two sides of horizontal position of the femoral head rotation center,vertical position of the rotation center and femoral offset(P<0.05).In the comparison of the good rate of Harris scores in each group,the good rate of Harris score in the acetabular abduction angle 35°~45° group and 45°~55° group were higher than ?35° group and >55° group.The good rate of Harris score in the rotation center horizontal position ratio 85%~100% group was higher than >100% group.The good rate of Harris score in the rotation center vertical position ratio 80%~120% group was higher than >160% group.The good rate of Harris score in the femoral offset ratio 90%~110% group and 110%~130% group are higher than ?90% group and >130% group.The difference was statistically significant(p<0.007).There was no significant difference in the good rate of Harris score between the groups of acetabular anteversion(p>0.05).In the comparison of modified Harris scores of each group,the Harris score in the acetabular abduction angle 35°~45° group and 45°~55° group were higher than ?35° group and >55° group.The Harris score in the acetabular anteversion angle 15°~25° group is higher than ?5° group and 5°~15° group.The Harris score in the rotation center horizontal position ratio 85%~100% group and 70%~85% group are higher than ?70% group and >100% group.The Harris score in the rotation center vertical position ratio 80%~120% group was the highest and 120%~160% group was higher than >160% group.The Harris score in the ratio of femoral offset 90%~110% group was the highest.The differences were statistically significant(p < 0.05).In the comparison of hip range of motion in each group,the hip range of motion of each group of acetabular abduction angle from high to low are 45° to 55°,35° to 45°,?35° and >55° group.The hip range of motion of each group of acetabular anteversion from high to low are 15° to 25°,5° to 15°,?5° and >25° group.The hip range of motion in the rotation center horizontal position ratio 85%~100% group and 70%~85% group are higher than ?70% group and >100% group.The hip range of motion in the rotation center vertical position ratio 80%~120% group was the highest.The hip range of motion of each group of femoral offset ratio from high to low are 90%~110% group,110%~130% group,>130% group and ?90% group.Conclusion:The results of this study indicate that in the early follow-up of THA,when the acetabular abduction angle was reconstructed at 35 °~55° rather than ?35°and >55°,the hip function recovery was better.However,when the acetabular abduction angle was reconstructed at 45°~55°,the optimal hip range of motion can be obtained.When the horizontal position of the femoral head rotation center was reconstructed in 0.85~1 time of the healthy side comparing with reconstructing in >1 times of the healthy side,better hip function recovery and the optimal hip range of motion was obtained.When the vertical position of the femoral head rotation center was reconstructed in 0.8~1.2 times of the healthy side comparing with reconstructing in >1.6 times of the healthy side,better hip function recovery and the optimal hip range of motion was obtained.The optimal reconstruction range of the femoral offset is 0.9 to 1.3 times of the healthy side.Reconstruction of the acetabular anteversion at 15°~25° may be the best option for THA acetabular prosthesis implantation,but further validation is needed. |
PDF Full Text Request