| 脊柱矢状面平衡与否对于指导髋臼假体定位的重要意义 |
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Received:September 16, 2020
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| 作者 | Author | 单位 | Unit | E-Mail |
| 黄楷甫 |
HUANG Kai-fu |
吉林大学第一医院骨关节外科, 吉林 长春 130000 |
Department of Joint Orthopaedics, No. 1 Hospital of Jilin University, Changchun 130000, Jilin, China |
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| 陈青阳 |
CHEN Qing-yang |
吉林大学第一医院骨关节外科, 吉林 长春 130000 |
Department of Joint Orthopaedics, No. 1 Hospital of Jilin University, Changchun 130000, Jilin, China |
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| 孙超 |
SUN Chao |
吉林大学第一医院骨关节外科, 吉林 长春 130000 |
Department of Joint Orthopaedics, No. 1 Hospital of Jilin University, Changchun 130000, Jilin, China |
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| 王凤萍 |
WANG Feng-ping |
吉林大学第一医院骨关节外科, 吉林 长春 130000 |
Department of Joint Orthopaedics, No. 1 Hospital of Jilin University, Changchun 130000, Jilin, China |
80473752@qq.com |
| 李叔强 |
LI Shu-qiang |
吉林大学第一医院骨关节外科, 吉林 长春 130000 |
Department of Joint Orthopaedics, No. 1 Hospital of Jilin University, Changchun 130000, Jilin, China |
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| 期刊信息：《中国骨伤》2021年34卷，第5期，第485-488页 |
| DOI：10.12200/j.issn.1003-0034.2021.05.018 |
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| 自Lewinnek提出的"安全区"概念以来便得到了大家的广泛认同，但近年来许多学者发现即使髋臼假体摆放在"安全区内"仍有很多人工髋关节置换术发生不明原因的假体脱位。并开始质疑"安全区"是否真的适合所有患者。脊柱退变、畸形，腰椎融合等会导致脊柱矢状面不平衡及骨盆活动的改变，进而导致髋臼方向的改变，最终导致人工全髋关节置换术后边缘负荷，磨损，撞击，甚至脱位等。从磨损、撞击和脱位等角度来看，是髋臼杯的功能定位所决定的，而不是解剖定位。对于站立位中性骨盆髋臼杯的解剖定位与功能定位可认为是等效的。而对于骨盆旋转>20°时则需考虑功能安放。近年来随着对脊柱-骨盆-髋关节之间的内在关系的认识愈发深刻，有学者根据脊柱是否僵硬、是否畸形将髋脊柱关系进一步分类，并根据不同类型的髋脊柱关系提出相应的髋臼的功能安放，从而达到稳定的人工髋关节。因此，术前充分评估患者矢状面是否平衡对于指导人工髋关节置换术具有重要的意义 |
| [关键词]:矢状面平衡 脊柱疾病 关节成形术,置换,髋 |
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| Significance of spinal sagittal balance for guiding acetabular prosthesis positioning |
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| Abstract:Since the concept of "safe area" put forward by Lewinnek, it has been widely recognized. While in recent years, many scholars have found that even if the acetabular prosthesis was placed on the "safe area", there were still many unexplained dislocation after total hip arthroplasty. And scholars began to question whether the "safe area" is really suitable for all patients. Spinal degeneration, deformity, lumbar fusion, etc. will lead to spine sagittal imbalance and changes in pelvic activity, which could lead to changes in acetabular orientation, and ultimately lead to edge loading, wear, impact, and even dislocation after total hip replacement. From the perspective of wear, impact and dislocation, it is determined by the functional positioning of the acetabular cup, not the anatomical positioning. The anatomical positioning and functional positioning of the neutral pelvic acetabular cup in the standing position can be considered equivalent. For pelvic rotation more than 20°, functional placement needs to be considered. In recent years, as the understanding of the internal relationship between the spine-pelvis-hip joint has become more and more profound, some scholars further classify the hip-spine relationship according to whether the spine is stiff or deformed, and propose corresponding acetabulums according to different types of hip-spine relationships The function of placement, so as to achieve a stable artificial hip joint. Therefore, it is of great significance to fully assess whether the patient's sagittal plane is balanced before surgery to guide artificial hip replacement surgery. |
| KEYWORDS:Sagittal balance Spinal diseases Arthroplasty,replacement,hip |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄楷甫,陈青阳,孙超,王凤萍,李叔强.脊柱矢状面平衡与否对于指导髋臼假体定位的重要意义[J].中国骨伤,2021,34(5):485~488 |
| 英文格式: | HUANG Kai-fu,CHEN Qing-yang,SUN Chao,WANG Feng-ping,LI Shu-qiang.Significance of spinal sagittal balance for guiding acetabular prosthesis positioning[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(5):485~488 |
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