Abstract:Objective To summarize the research progress on hip joint center (HJC)reconstruction in total hip arthroplasty. Methods Studies published from January 2005 to September 2021 in the database of CNKI, Wanfang, and PubMed were searched using the following keywords: "旋转中心" "髋" "关节置换" "rotation center" "hip" and "arthroplasty". Of the 652 studies, 43 were analyzed and summarized. Other studies were excluded because they were inconsistent with the subject, had no full text, had low quality and level of evidence, and were repeated studies. Results The common anatomic marks related to HJC reconstruction are the tip of the greater trochanter and the lesser trochanter, the acetabular notch, the Harris fossa, and the acetabular teardrop. The femoral head rotation center can be reconstructed with reference to the contralateral greater and lesser trochanter tips and their distance to the HJC. The acetabular rotation center can also be reconstructed with reference to the acetabular notch, the Harris fossa, and the acetabular teardrops. Through 3D printing technology, the HJC can be accurately located by printing an individual acetabular model, and acetabular and femoral head locators can be prepared. Operators can also have an opportunity to simulate and perform this operation more accurately depending on individual needs. Computer-assisted navigation systems are divided into two types: computed tomography-based systems and imageless systems. Their working principle involves registry of anatomical marks through positioning points, establishment of a hip joint model, and localization of the HJC. The former localization of the HJC is based on patients' preoperative imaging data, which may affect the accuracy of HJC localization because of slight differences between image displays and actual situations. By comparison, the latter refers to the anatomical landmarks of a surgical area for localizing the HJC and has higher localization accuracy. Robot-assisted total hip arthroplasty systems use computer software to convert a patient's imaging anatomy information into virtual and individualized three-dimensional reconstruction images of the pelvis and thus plan the optimal localization of an implant. During the operation, the robot can accurately carry out an individual operation plan, thereby improving the accuracy of acetabular prosthesis positioning and HJC and reducing the rate of dislocation. Conclusion In total hip arthroplasty, appropriate anatomical marks and parameters are selected according to the anatomical characteristics of the hip joint. Thus, the rotation center of the hip joint can be accurately reconstructed through a combination of 3D printing technology, computer-assisted navigation system, orthopedic robots, and other digital technologies.
田最, 高振中, 尹志文, 王泽华, 郭子瑊, 向川. 全髋关节置换术中髋关节旋转中心重建方法的研究进展[J]. 中华解剖与临床杂志, 2022, 27(6): 438-443.
Tian Zui, Gao Zhenzhong, Yin Zhiwen, Wang Zehua, Guo Zijian, Xiang Chuan. Research progress on rotation center reconstruction in total hip arthroplasty. Chinese Journal of Anatomy and Clinics, 2022, 27(6): 438-443.
Boymans T, Veldman HD, Noble PC, et al.The femoral head center shifts in a mediocaudal direction during aging[J]. J Arthroplasty, 2017, 32(2):581-586. DOI: 10.1016/j.arth.2016.07.011.
[2]
Bombaci H, Simsek B, Soyarslan M, et al.Determination of the hip rotation centre from landmarks in pelvic radiograph[J]. Acta Orthop Traumatol Turc, 2017,51(6):470-473. DOI: 10.1016/j.aott.2017.09.004.
[3]
Goudie ST, Deakin AH, Deep K.Natural acetabular orientation in arthritic hips[J]. Bone Joint Res, 2015,4(1):6-10. DOI: 10.1302/2046-3758.41.2000286.
[4]
Schultz K, Ewbank ML, Pandit HG.Changing practice for hip arthroplasty and its implications[J]. Br J Nurs, 2017,26(22):1238-1244. DOI: 10.12968/bjon.2017.26.22.1238.
[5]
Lazennec JY, Folinais D, Florequin C, et al.Does patients' perception of leg length after total hip arthroplasty correlate with anatomical leg length?[J]. J Arthroplasty, 2018,33(5):1562-1566. DOI: 10.1016/j.arth.2017.12.004.
[6]
Kayani B, Konan S, Thakrar RR, et al. Assuring the long-term total joint arthroplasty: a triad of variables[J]. Bone Joint J, 2019,101-B(1_Supple_A):11-18. DOI: 10.1302/0301-620X.101B1.BJJ-2018-0377.R1.
[7]
Hambright D, Hellman M, Barrack R. Intra-operative digital imaging: assuring the alignment of components when undertaking total hip arthroplasty[J]. Bone Joint J, 2018,100-B(1 Supple A):36-43. DOI: 10.1302/0301-620X.100B1.BJJ-2017-0596.R1.
[8]
Benson JR, Govindarajan M, Muir JM, et al.Surgical approach and reaming depth influence the direction and magnitude of acetabular center of rotation changes during total hip arthroplasty[J]. Arthroplast Today, 2020,6(3):414-421. DOI: 10.1016/j.artd.2020.04.003.
[9]
Panichkul P, Pinsornsak P.Radiographic measurement to restore femoral head center in hip arthroplasty[J]. J Med Assoc Thai, 2012, 95(Suppl 10):S32-S36.
[10]
Dhinsa BS, Saini A, Dick AG, et al.Accuracy of the relationship between the centre of the femoral head and tip of greater trochanter[J]. J Clin Orthop Trauma, 2019,10(4):674-679. DOI: 10.1016/j.jcot.2018.08.020.
[11]
路玉峰, 郭万首, 孙伟, 等. X线研究大转子顶点与股骨头中心的关系[J].中华关节外科杂志(电子版),2016,10(6):609-612. D0I:10.3877/cma.j.issn.1674-134X.2016.06.005Lu YF,Guo WS,Sun W,et al.Radiological assessment on relationship between greater trochanter tip and femoral head center[J]. Chin J Joint Surg (Electonic Version), 2016,10(6):609-612.DOI:10.3877/cma.j.issn.1674-134X.2016.06.005.
[12]
Kumar A, Passey J, Kumar M, et al.Reliability of relation between greater trochanter and center of rotation of femoral head in Indian population[J]. J Clin Orthop Trauma, 2020,11(Suppl 4):S522-S525. DOI: 10.1016/j.jcot.2020.04.017.
[13]
杨小龙, 许峰, 张中兴. THA中大转子顶点到股骨头中心的距离对于重建股骨偏心距的意义[J].实用骨科杂志,2017,23(12):1136-1138. DOI:10.13795/j.cnki.sgkz.2017.12.022Yang XL,Xu F,Zhang ZX,et al.The significance of the distance from the apex of the greater trochanter to the center of the femoral head in THA for the reconstruction of femoral eccentricity[J]. Journal of Practical Orthopaedics,2017, 23(12): 1136-1138. DOI: 10.13795/j.cnki.sgkz.2017.12.022.
[14]
Hasler J, Hoch A, Fürnstahl P, et al.Is the contralateral lesser trochanter a reliable reference for planning of total hip arthroplasty-a 3-dimensional analysis[J]. BMC Musculoskelet Disord, 2021, 22(1):268. DOI: 10.1186/s12891-021-04131-w.
[15]
Wang G, Guo A, Yu F, et al.A simple method to minimize leg length discrepancy in hip hemiarthroplasty[J]. Clin Interv Aging, 2019,14:1601-1605. DOI: 10.2147/CIA.S214935.
[16]
王瑞, 陈哲峰, 程蒋琪, 等. 基于CT断层影像的髋关节假斜位X线片拍摄中骨盆旋转角度验证标准的研究[J].中华解剖与临床杂志,2020,25(6):634-639. DOI:10.3760/cma.j.cn101202-20200302-00057.Wang R,Chen ZF,Cheng JQ,et al.The verification standard of rotation angle of hip false profile X-ray film based on CT scan.[J].Chin J Anat Clin,2020,25(6):634-639.DOI:10.3760/cma.j.cn101202-20200302-00057.
[17]
周建生, 王坤正, 官建中, 等. 复原髋臼窝在Crowe Ⅲ型髋关节发育不良精准全髋置换中的作用及影像学量化评分[J].中华解剖与临床杂志,2021,26(4):435-442. DOI:10.3760/cma.j.cn101202-20210329-00088.Zhou JS,Wang KZ, Guan JZ,et al.Acetabular fossa restoration in precise total hip arthroplasty for Crowe type Ⅲ developmental hip dysplasia and its radiological quantitative score[J]. Chin J Anat Clin, 2021, 26(4):435-442. DOI:10.3760/cma.j.cn101202-20210329-00088.
[18]
Govsa F, Ozer MA, Ozgur Z.Morphologic features of the acetabulum[J]. Arch Orthop Trauma Surg, 2005,125(7):453-461. DOI: 10.1007/s00402-005-0020-6.
[19]
周建生, 官建中, 王志岩, 等. 成人髋关节发育不良髋臼和Harris窝解剖特征及在全髋置换术中旋转中心重建的意义[J].中华关节外科杂志(电子版), 2015, 9(3):352-357. DOI:10.3877/cma.i.issn.1674-134X.2015.03.015.Zhou JS, Guan JZ, Wang ZY, et al.Anatomical featnes of Harris fasea and acelabulum in adult developmental dyeplasia of hip and : ignifcance of rotation center reconsirue tion in total hip athoplst[J]. Chin J Joint Surg (Electonic Version),2015.9(3):352-357. DOI:10.3877/cma.j.issn.1674-134X.2015.03.015.
[20]
吴一凡, 周新社, 裴立家. 直接前方入路全髋关节置换术治疗高脱位型髋关节发育不良的临床应用[J].中华解剖与临床杂志,2021,26(2):188-192. DOl:10.3760/cma.j.cn101202-20201026-00370.Wu YF,Zhou XS,Pei LJ,et al.Clinical application of direct anterior approach for total hip arthroplasty as a treatment of high dislocation type hip dysplasia[J]. Chin J Anat Clin, 2021, 26(2):188-192. DOI:10.3760/cma.j.cn101202-20201026-00370.
[21]
Zhang H, Zhou J, Guan J, et al.How to restore rotation center in total hip arthroplasty for developmental dysplasia of the hip by recognizing the pathomorphology of acetabulum and Harris fossa?[J]. J Orthop Surg Res, 2019,14(1):339. DOI: 10.1186/s13018-019-1373-9.
[22]
Li J, Gao X, Yang G, et al.Using acetabular fossa as a guide for anticipated inclination of uncemented cup in total hip replacement[J]. Int J Clin Exp Med, 2015,8(1):181-187.
[23]
Zhang H, Zhou J, Liu Y, et al.Mid-term and long-term results of restoring rotation center in revision hip arthroplasty[J]. J Orthop Surg Res, 2020,15(1):152. DOI: 10.1186/s13018-020-01670-1.
[24]
Merle C, Waldstein W, Pegg E, et al.Femoral offset is underestimated on anteroposterior radiographs of the pelvis but accurately assessed on anteroposterior radiographs of the hip[J]. J Bone Joint Surg Br, 2012,94(4):477-482. DOI: 10.1302/0301-620X.94B4.28067.
[25]
Nawabi DH, Meftah M, Nam D, et al.Durable fixation achieved with medialized, high hip center cementless THAs for Crowe Ⅱ and Ⅲ dysplasia[J]. Clin Orthop Relat Res, 2014, 472(2):630-636. DOI: 10.1007/s11999-013-3187-0.
[26]
Shao P, Li Z, Yang M, et al.Impact of acetabular reaming depth on reconstruction of rotation center in primary total hip arthroplasty[J]. BMC Musculoskelet Disord, 2018,19(1):425. DOI: 10.1186/s12891-018-2336-8.
[27]
路玉峰, 郭万首, 孙伟, 等. 泪滴下缘在全髋关节置换重建髋臼解剖中心高度中的作用[J].中国组织工程研究,2018,22(11):1641-1646. DOI: 10.3969/j.issn.2095-4344.0156.Lu YF,Guo WS,Sun W,et al.Application of lower edge of teardrop on restoring anatomical hip center height in total hip arthroplasty[J]. Chinese Journal of Tissue Engineering,2018, 22(11):1641-1646. DOI: 10.3969/j.issn.2095-4344.0156.
[28]
Sánchez-Pérez C, Rodríguez-Lozano G, Rojo-Manaute J, et al.3D surgical printing for preoperative planning of trabecular augments in acetabular fracture sequel[J]. Injury, 2018, 49(Suppl 2):S36-S43. DOI: 10.1016/j.injury.2018.07.014.
[29]
Li Q, Chen X, Lin B, et al.Three-dimensional technology assisted trabecular metal cup and augments positioning in revision total hip arthroplasty with complex acetabular defects[J]. J Orthop Surg Res, 2019,14(1):431. DOI: 10.1186/s13018-019-1478-1.
[30]
Cao L, Wang Y, Zou S, et al.A novel positioner for accurately sitting the acetabular component: a retrospective comparative study[J]. J Orthop Surg Res, 2019,14(1):279. DOI: 10.1186/s13018-019-1331-6.
[31]
梁金龙, 赵永辉, 陆地, 等. 个体化股骨头导板在髋关节表面置换术中应用的实验研究[J].中华解剖与临床杂志,2020,25(4):359-364. DOI:10.3760/cma.j.cn101201-20191030-00326.Liang JL, Zhao YH, Lu D, et al.Pilot research of custom-made navigational template of femoral head in total hip resurfacing arthroplasty.[J].Chin J Anat Clin,2020,25(4):359-364. DOI:10.3760/cma.j.cn101201-20191030-00326.
[32]
Deep K, Shankar S, Mahendra A.Computer assisted navigation in total knee and hip arthroplasty[J]. SICOT J, 2017,3:50. DOI: 10.1051/sicotj/2017034.
[33]
Kayani B, Konan S, Ayuob A, et al.The current role of robotics in total hip arthroplasty[J]. EFORT Open Rev, 2019,4(11):618-625. DOI: 10.1302/2058-5241.4.180088.
[34]
Wasterlain AS, Buza JA, Thakkar SC, et al.Navigation and robotics in total hip arthroplasty[J]. JBJS Rev, 2017,5(3):e2. DOI: 10.2106/JBJS.RVW.16.00046.
[35]
Mihalič R, Zdovc J, Mohar J, et al.Electromagnetic navigation system for acetabular component placement in total hip arthroplasty is more precise and accurate than the freehand technique: a randomized, controlled trial with 84 patients[J]. Acta Orthop, 2020,91(6):675-681. DOI: 10.1080/17453674.2020.1783073.
[36]
Kubota Y, Kaku N, Tabata T, et al.Efficacy of computed tomography-based navigation for cup placement in revision total hip arthroplasty[J]. Clin Orthop Surg, 2019,11(1):43-51. DOI: 10.4055/cios.2019.11.1.43.
[37]
Nishihara S, Hayashida K.Comparison between freehand technique and computed tomography-based navigation in acetabular cup placement through direct anterior approach for total hip arthroplasty[J]. Arch Orthop Trauma Surg, 2022, 142(2):323-329. DOI: 10.1007/s00402-021-03920-1.
[38]
Banerjee S, Cherian JJ, Elmallah RK, et al.Robot-assisted total hip arthroplasty[J]. Expert Rev Med Devices, 2016,13(1):47-56. DOI: 10.1586/17434440.2016.1124018.
[39]
Han PF, Chen CL, Zhang ZL, et al.Robotics-assisted versus conventional manual approaches for total hip arthroplasty: a systematic review and meta-analysis of comparative studies[J]. Int J Med Robot, 2019,15(3):e1990. DOI: 10.1002/rcs.1990.
[40]
Snijders TE, Schlösser T, van Straalen M, et al. The effect of postural pelvic dynamics on the three-dimensional orientation of the acetabular cup in THA is patient specific[J]. Clin Orthop Relat Res, 2021,479(3):561-571. DOI: 10.1097/CORR.0000000000001489.
[41]
Clement ND, Gaston P, Bell A, et al.Robotic arm-assisted versus manual total hip arthroplasty[J]. Bone Joint Res, 2021,10(1):22-30. DOI: 10.1302/2046-3758.101.BJR-2020-0161.R1.
[42]
Nd RLI, Bukowski BR, Abiola R, et al.Robotic-assisted total hip arthroplasty: outcomes at minimum two-year follow-up[J]. Surg Technol Int, 2017,30:365-372.
[43]
Ando W, Takao M, Hamada H, et al.Comparison of the accuracy of the cup position and orientation in total hip arthroplasty for osteoarthritis secondary to developmental dysplasia of the hip between the Mako robotic arm-assisted system and computed tomography-based navigation[J]. Int Orthop, 2021, 45(7):1719-1725. DOI: 10.1007/s00264-021-05015-3.