Accuracy Of Acetabular Anteversion Angle Positioning Reference To Acetabular Transverse Ligament During Total Hip Arthroplasty

BackgroundWith improving of our life quality and the medical technology,the life expectancy has been improved and the aging society has coming.More and more aging people get aseptic necrosis of femoral head、coxitis and fracture of the femoral neck and many of them are sent to hospital because of these factors.The accuracy of the prosthesis of the acetabulum is the key factor influencing the success of the THA.Futhermore,the anteversion angle and the inclination angle is now the most important factors judging the accuracy of the prosthesis.Most of our expertise are now using the acetabular locator or their experience to position the prosthesis.Currently,some people come up with the idea of positioning the prosthesis by transverse ligament.We choose the patients who have their primary THA in the Taishan medical university affilitated hospital to make sure whether the transverse ligament can improve the accuracy of the prosthesis.Objective(1)To explore whether the position of acetabular prosthesis oritented by TAL can improve the accuracy of positioning.(2)To explore whether the dislocation can be reduced by positioning the prosthesis reference to TAL.MethodsThe Taishan medical university affilitated hospital can do the THA approximately 300 every year.Then we choose 60 patients who had the THA in Taishan medical university affilitated hospital from 2014 to 2015.In these 60 patients who had their prosthesis oriented by TAL served as the study group,others who had their prosthesis positioned by the aceta bular locator served as the control group.The anteversion of all the patients are calculated by the Lewinnek method.And we also track these patients to record the disloca-tion after the THA.Build a data base,and the statistical analyse was performed by the SPSS 13.0.The analyse of the anteversion is measured by independent T-test.The statistical analyse of the dislocation is measured by Chi-square test.ResultsDuring the operation,36 patients were able to recognize the transverse acetabular ligament and then the prosthesis would be oriented by the TAL,The TAL could not be identified in the other 24 patients.And these patients would use the locator to position the prosthesis.All patients wereⅠincision healing.The groups were followed up for 10 to 17 months,an average of 14 months.None dislocation could be found in the study group and in the control group we also get the same result.Postoperative acetabular anteversion angle in study group was(15.21±4.58)°,and had no statistically significant(P>0.05)comparing with control group(15.12±8.32)°.The difference was not statistically significant(P> 0.05)between the anteversion angle of thw two groups and normal angle(15±10)°.ConclusionUsing the TAL to orient the acetabular prosthesis is accuracy.Not all cases can clearly distinguish transverse acetabular ligament during total hip replacement surgery.Comparing with the control group,TAL could not improve the accuracy of the positioning of the prosthesis.Oriented by TAL could not improve the dislocation effectively.