应用髋臼横韧带确定术中髋臼杯外展角
The Transverse Acetabular Ligament as an Intraoperative Guide to Cup Abduction
Background: The success of a total hip arthroplasty relies on optimal acetabular cup placement to ensure mating of the femoral head and acetabular cup throughout all positions of the hip joint. Poor cup placement is associated with dislocation, impingement, microseparation, component loosening, and accelerated wear due to rim loading. This study examined a novel method of using the transverse acetabular ligament (TAL) to guide cup inclination during primary total hip arthroplasty.
Methods: A descriptive study using 16 hips from 9 cadavers. A computer navigation system measured inclination and version of the acetabular component in 3 positions with the lower edge of cup: (1) flush with, (2) 5 mm proximal to, and (3) 5 mm distal to free border of the TAL.
Results: The median inclination angles were 44° in position (1), 30° in position (2), and 64° in position (3). The median anteversion angle for all positions was 19°.
Conclusion: Cup inclination was acceptable when the lower edge of the cup was flush or within 5 mm proximal to the TAL.
应用髋臼横韧带确定术中髋臼杯外展角
译者：张峻
背景：全髋关节置换术的成功取决于理想的髋臼杯安放，以确保股骨头和髋臼杯在髋关节的所有位置都能很好地匹配。髋臼杯位置不良与脱位、撞击、微分离、假体松动以及由于边缘负荷致磨损加速有关。本研究探讨了一种在初次全髋关节置换术中应用髋臼横韧带（TAL）确定髋臼杯外展角的新方法。
方法：采用9具尸体16髋进行描述性研究。计算机导航系统测量髋臼假体在3个位置的外展角，分别为髋臼杯下缘：（1）与TAL平齐，（2）距TAL自由缘近5mm，（3）距TAL自由缘远5mm。
结果：中位外展角度（1）为44°，中位外展角度（2）为30°，中位外展角度（3）为64°。3种不同位置的前倾角中位数为19°。
结论：当杯底边缘齐平TAL或距TAL近5mm范围内时，髋臼杯外展角可接受。
文献出处：Hiddema WB, van der Merwe JF, van der Merwe W. The Transverse Acetabular Ligament as an Intraoperative Guide to Cup Abduction. J Arthroplasty. 2016 Jul;31(7):1609-13. doi: 10.1016/j.arth.2016.01.019. Epub 2016 Jan 21. PMID: 26897492.