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The Changes in Coronal Spino-Pelvis Alignment in Patients with Developmental Hip Dysplasia after Total Hip Arthroplasty |
LUO Jinwei, ZHANG Lichao, WU Di, et al |
Chengde Medical University Affiliated Hospital, Hebei Chengde 067000, China |
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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.
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