| BackgroundOne of the important factors determining the efficacy of total hip arthroplasty(THA)is the location of the component.Acetabulum component ideal position(ABA 40°+10°,AVA 20°+5°)accurate placement,to ensure the good joint range of normal wear and friction interface,effectively reduce the risk of postoperative dislocation,guaranteed the clinical curative effect of THA.When combined with hip and spinal-pelvic deformities,THA patients are often unable to use anatomical markers and spatial localization due to fixed deformities and subsequent compensation,making it difficult to position the acetabular component in the "safe range",thus increasing joint dislocation and wear.And the "safe range" is not easily ensured in surgery,including ankylosing spondylitis(AS).For ankylosing spondylitis,sagittal deformity is more common.ObjectiveTo explore the factors affecting acetabular component orientation on sagittal pelvis variation in patients with non-stiff spine ankylosing spondylitis in toatal hip arthroplasty.Contens and methodsThe subjects of this study were 37 cases of AS induced hip rigidity deformity treated by total hip arthroplasty surgery in our hospital from February 2010 to May 2016,among which 33 cases were males and 4 cases were females,aged from 20 to 66 years,with an average of 33.9 years.The duration of hip involvement was 2 to 18 years,with an average of 8.4 years.All patients underwent unilateral total hip arthroplasty and were followed up for at least 1 year.In preoperative and postoperative 1 year by Harris hip score evaluation system(HHS)and hip joint mobility in patients with hip joint function and activity recovery of hip joint,take the method of visual analog pain score(VAS)evaluation of hip pain symptoms,choose life index score(SF-36)to assess the patients life quality improvement.Respectively by pelvic incidence Angle(pelvic incidence,PI),pelvic tilt Angle(pelvic tilt,PT)and sacral slope Angle(sacral slope,SS)and 1 month after acetabulum component devices for Angle(acetabular anteversion,AVA)and(acetabular abduction,ABA)relationship,then compare the preoperative and postoperative 1 month and after one year before the acetabulum obliquity,abducent angles(acetabular abduction,ABA).Results37 patients were followed up for at least 1 year,the general situation of HHS score from(28.8 + 13.8)points preoperatively to postoperative(82.5-9.9),and the pain VAS score by preoperative(5.6 + 0.7)points to surgery(1.4 + 0.5)points,life index score(SF-36)from(17.5 + 11.6)points preoperatively to postoperative(75.2-12.8),the difference was statistically significant(P < 0.05);At the time of the last follow-up after buckling,stretch,adduction,abduction and internal rotation and external rotation Angle of(108.9 + 11.7)°,(8.4-4.6)°,(13.2-3.7)°,(40.5-5.8)°,(11.8-3.7)°,(37.1-5.7)°,were significantly higher than that of preoperative(57.9 + 27.4)°,(1.1-2.6)°,(5.5-7.6)°,(14.7-13.4)°,(2.9-4.4)°,(12.9-16.4)°,the difference was statistically significant(P < 0.05).There was no significant difference between AVA and PI and SS 1 month after surgery(P>0.05).Compared with PT,the differences were statistically significant(P<0.05).The anterior Angle of acetabular component increased significantly after surgery(P<0.05),and decreased with the correction of pelvic retrograde(P<0.05).Conclusionsagittal pelvis variation in patients with non-stiff spine ankylosing spondylitis,PT was significantly correlated with the AVA of acetabular component.The AVA of acetabular component increased after surgery,but decreased with the limited balance of the spinal-pelvic relationship.Total hip arthroplasty can significantly improve hip function,reduce pain and improve quality of life... |
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