摘要目的: 探讨发育性髋关节发育不良(developmental dysplasia of the hip,DDH)患者进行全髋关节置换术(total hip arthroplasty,THA)后脊柱冠状位序列变化的影响。方法: 纳入2021年3月至2023年12月我院进行全髋置换术临床资料完整的DDH患者22例,男9例、女13例;平均年龄54.23±10.07岁。左侧19例,右侧3例。记录术前和术后站立位脊柱全长正侧位X线片及站立位下肢全长正侧位X线片,测量脊柱-骨盆冠状位参数:Cobb角、下肢长度、骶骨倾斜角、髂骨倾斜角、腰5(L5)倾斜角、CE角。分析冠状位脊柱-骨盆参数之间的相关性。结果: 全髋关节置换术前下肢长度为83.77±4.33cm,术后下肢长度为84.02±1.01cm,差异无统计学意义(P>0.05);术前术后的下肢对比健侧肢体的长度差值的差异有统计学意义(P<0.05);骶骨倾斜角由术前4.38±5.62度至4.62±5.43度,差异无统计学意义(P>0.05);髂骨倾斜角术前为58.19±3.20度,术后为51.00±3.89度,差异有统计学意义(P<0.05);术前CE角度为19.34±7.17度,术后角度为56.21±9.10度,差异有统计学意义(P<0.05); Cobb角位5.70±4.34度,术后为6.03±3.65度,差异无统计学意义(P>0.05);L5倾斜角术前为2.75±1.93度,术后为2.47±1.91度,差异无统计学意义(P>0.05)。骶骨倾斜角与髂骨倾斜角,L5倾斜角存在相关性(r=0.462,P=0.030;r=0.437,P=0.042)。结论: 对于DDH患者在经过人工全髋置换术后肢体长度的差异得到改善,骨盆的冠状位倾斜得到一定矫正,下腰部的力学形态得到改善,可能对于下腰痛有一定的缓解。
Abstract：Objective: To investigate the changes in coronal spino-pelvis alignment after total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Methods: Twenty-two DDH patients who underwent THA in our hospital from March 2021 to December 2023 were included,comprising 9 males and 13 females with a mean age of 54.23±10.07 years.Among them,19 cases involved the left side and 3 cases involved the right side.Preoperative and postoperative standing full-length anteroposterior and lateral radiographs of the spine and lower extremities were recorded.The following coronal spino-pelvis parameters were measured:Cobb angle,lower limb length,sacral obliquity,iliac obliquity,L5 obliquity,and CE angle.The correlations between these parameters were analyzed. Results: The lower limb length changed from 83.77±4.33 cm preoperatively to 84.02±1.01 cm postoperatively,with no statistically significant difference (P>0.05).However,the difference in lower limb length compared to the healthy limb showed a statistically significant change (P<0.05).The sacral obliquity increased from 4.38±5.62° preoperatively to 4.62±5.43° postoperatively,with no statistically significant difference (P>0.05).The iliac obliquity decreased from 58.19±3.20° preoperatively to 51.00±3.89° postoperatively,showing a statistically significant difference (P<0.05).The CE angle increased from 19.34±7.17° preoperatively to 56.21±9.10° postoperatively,with a statistically significant difference (P<0.05).The Cobb angle changed from 5.70±4.34° preoperatively to 6.03±3.65° postoperatively,with no statistically significant difference (P>0.05).The L5 obliquity changed from 2.75±1.93° preoperatively to 2.47±1.91° postoperatively,with no statistically significant difference (P>0.05).Sacral obliquity was correlated with iliac obliquity and L5 obliquity (r=0.462,P=0.030; r=0.437,P=0.042). Conclusion: THA improved the limb length discrepancy in DDH patients,corrected the coronal obliquity of the pelvis,and improved the mechanical morphology of the lower lumbar region,which may provide some relief for lower back pain.
罗金伟, 张立超, 吴迪, 武丽珠, 张利强. 全髋关节置换术对发育性髋关节发育不良患者脊柱冠状位线的影响[J]. 河北医学, 2025, 31(4): 687-691.
LUO Jinwei, ZHANG Lichao, WU Di, et al. The Changes in Coronal Spino-Pelvis Alignment in Patients with Developmental Hip Dysplasia after Total Hip Arthroplasty. HeBei Med, 2025, 31(4): 687-691.
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2025, Vol. 31 
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