Zhongguo gu shang = China journal of orthopaedics and traumatology · 2025
[Calculation of personalized safety zone of hip joint prosthesis in patients with ankylosing spondylitis and analysis of influencing factors].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Chen Yin-Xi, Liu Geng, Fu Peng-Ge, Wang Qi-Zhong, Wang Yu-Xin, Li Hui
Аннотация
OBJECTIVE: To explore safe zones for acetabular prosthesis implantation in patients with ankylosing spondylitis (AS) at different anterior pelvic plane tilts (APPt), and to determine the optimal implantation angle of the prosthesis through the safe zones with different ranges of motion. To explore the influencing factors of size and scope of the safe zone.
METHODS: CT data of pelvis before total hip arthroplasty (THA) in a 54-year-old male patient with Tonnis stage Ⅳ left hip arthritis, and virtual THA simulated by computer prosthesis with a femoral head diameter of 32 mm, a head-to-neck ratio of 2.67, and a cervical-shaft angle of 132° was selected and assembled by tilting forward by 15°. After defining the target range of motion of hip joint that could meet functions such as standing, sitting, and squatting, acetabular prosthesis implantation safety zones corresponding to bony impact and prosthesis impact when the anterior pelvic plane inclination angles are -10°, -5°, 0°, 5°, 10°, 15°, 20° and 25° respectively were calculated. A model to change the parameters of the femoral prosthesis was select and calculated the safety zone when different prostheses were implanted.
RESULTS: When the range of motion of spine and pelvis disappeared, the safe zone for implant placement could meet the requirements of standing, sitting and squatting was extremely small. When the pelvis was tilted forward by 10° to backward by 25°, the abduction angle of acetabular implant could meet the daily range of motion decreased from 55.7° to 45.8°, and the forward inclination angle decreased from 29.9° to 7.4°. The diameter of femoral head was positively correlated with the size of safe zone. Within the range of 24 to 32 mm, for every 0.17 mm increased in the diameter of femoral head, the safe range of acetabular anterior inclination angle and abduction angle increased for 4° to 6°. For the ball head of the same diameter, the safety zone showed a trend of first increasing and then decreased with the increase of cervical shaft angle or anterior inclination angle of femur.
CONCLUSION: When AS patients undergo THA, precise implantation techniques are required to obtain a safe range of motion that could meet the requirements of standing, sitting and squatting. For patients with obvious anterior or posterior pelvic tilt, personalized prosthesis implantation should be carried out to reduce prosthesis suspension and impact on the iliopsoas muscle. Large-diameter femoral head prostheses are more sensitive to changes in the cervical shaft angle and anterior inclination angle, and the area of the implanted combined safety zone is larger.
METHODS: CT data of pelvis before total hip arthroplasty (THA) in a 54-year-old male patient with Tonnis stage Ⅳ left hip arthritis, and virtual THA simulated by computer prosthesis with a femoral head diameter of 32 mm, a head-to-neck ratio of 2.67, and a cervical-shaft angle of 132° was selected and assembled by tilting forward by 15°. After defining the target range of motion of hip joint that could meet functions such as standing, sitting, and squatting, acetabular prosthesis implantation safety zones corresponding to bony impact and prosthesis impact when the anterior pelvic plane inclination angles are -10°, -5°, 0°, 5°, 10°, 15°, 20° and 25° respectively were calculated. A model to change the parameters of the femoral prosthesis was select and calculated the safety zone when different prostheses were implanted.
RESULTS: When the range of motion of spine and pelvis disappeared, the safe zone for implant placement could meet the requirements of standing, sitting and squatting was extremely small. When the pelvis was tilted forward by 10° to backward by 25°, the abduction angle of acetabular implant could meet the daily range of motion decreased from 55.7° to 45.8°, and the forward inclination angle decreased from 29.9° to 7.4°. The diameter of femoral head was positively correlated with the size of safe zone. Within the range of 24 to 32 mm, for every 0.17 mm increased in the diameter of femoral head, the safe range of acetabular anterior inclination angle and abduction angle increased for 4° to 6°. For the ball head of the same diameter, the safety zone showed a trend of first increasing and then decreased with the increase of cervical shaft angle or anterior inclination angle of femur.
CONCLUSION: When AS patients undergo THA, precise implantation techniques are required to obtain a safe range of motion that could meet the requirements of standing, sitting and squatting. For patients with obvious anterior or posterior pelvic tilt, personalized prosthesis implantation should be carried out to reduce prosthesis suspension and impact on the iliopsoas muscle. Large-diameter femoral head prostheses are more sensitive to changes in the cervical shaft angle and anterior inclination angle, and the area of the implanted combined safety zone is larger.