髋臼横韧带可作为臼杯前倾角安放的参考

目的通过对骨盆CT及三维重建图像测量髋臼横韧带(TAL)的解剖学前倾角，以明确其是否可以作为臼杯前倾角安放的参考。 方法研究选取自2017年1月至2018年12月行骨盆CT三维重建且无明显骨性解剖异常的成年人共87例(174髋)，其中男49例(98髋)，女38例(76髋)。通过三维重建图像测量TAL解剖学前倾角，比较性别、左右侧别及年龄差异，统计位于安全区内的比例。测量髋臼解剖学前倾角，比较其与髋臼横韧带之间的差异。应用独立样本t检验或配对t检验比较性别及侧别间差异，应用单向方差分析比较年龄组间的差异。 结果髋臼解剖学前倾角的均值为(22±4)°，性别之间(t＝-1.491)及侧别组间(t＝-1.518)差异无统计学意义(P>0.05)。TAL解剖学前倾角均值为(18±5)°，性别之间(t＝-0.319)、侧别之间(t＝-1.437)差异无统计学意义(P>0.05)，年龄组间差异亦无统计学意义(F ＝0.828，P>0.05)，位于安全区内的比例为98.85%。TAL解剖学前倾角小于髋臼解剖学前倾角，差异有统计学意义(t＝7.859，P<0.001)。 结论在无髋臼发育异常患者中，TAL可以作为全髋关节置换术中臼杯前倾角安放的参考。

Transverse acetabular ligament can be used as landmark for anteversion of cup

ObjectiveTo evaluate the reference value of transverse acetabular ligament to the proper placement of the artificial cup during total hip arthroplasty. MethodsThere were 87 patients (174 hips) who met the inclusion and exclusion criteria from January 2017 to December 2018, including 49 males (98 hips) and 38 females (76 hips). The anatomical anteversion of the transverse acetabular ligament on three-dimensional reconstruction images of the pelvic were measured and the differences in gender, laterality as well as different ages were compared and the proportion of the safe-zone was calculated. The anatomical anteversion of the acetabulum was also measured and the differences in gender and laterality were compared. Independent-sample t-test or paired-sample t test were used to compare the differences of gender and side, and one-factor analysis of variance was used to analyze the difference between different ages. ResultsThe mean values of anatomical anteversion of acetabular was (22± 4)°, without significant difference in gender and laterality (t =-1.491, -1.518, both P >0.05). The mean values of anatomical anteversion of acetabular was (18±5)°, without statistically significant difference in gender and laterality (t =-0.319, -1.437, both P >0.05)). No statistically significant difference was found among different age groups (F =0.828, P>0.05). The proportion of the cups in the safe area was 98.85%.The values of anatomical anteversion of acetabular was smaller than the values of anatomical anteversion of acetabular with statistically significant difference(t=7.859, P<0.001). ConclusionIn patients without acetabular dysplasia, transverse acetabular ligament can be used as a valuable intraoperative reference mark for the placement of the cup during the total hip arthroplasty surgery.