用髋臼横韧带定位髋臼假体：你能找到它吗？方法是否有效？

来源：304关节学术

使用髋臼横韧带定位髋臼假体：

你能找到它吗？方法是否有效？

译者：张峻

背景：多项研究表明髋臼横韧带（TAL）可用于全髋关节置换术中髋臼假体的定位，几乎在所有患者中能找到它。

目的：我们试图确定TAL在初次全髋关节置换术中被找到的频率及其作为髋臼假体定位导向的准确性。

方法：对63例（64髋）接受全髋关节置换术的患者进行前瞻性研究，两位外科医生试图确定髋臼假体的位置，术中找到TAL后作为参考来明确髋臼假体的方向。术中明确找到TAL的患者作为实验组，并且使用其作为臼杯定位；其余无法确定TAL的患者作为对照组，进行徒手定位。前倾角由标准侧位x线测量确定。

结果：只在30个髋关节（47%）找到了TAL，在没有髋臼下缘骨赘的患者中更易找到。使用此韧带作为参考髋臼杯的位置没有改善。

结论：TAL不能在手术中常规找到，当用于臼杯定位时并不比徒手置杯更准确。

Acetabular component positioning using the transverse acetabular ligament: can you find it and does it help?

Background: Several studies have reported that the transverse acetabular ligament (TAL) can be used to orient the acetabular component during total hip arthroplasty and that it can be identified in nearly all patients.

Questions/purposes: We attempted to determine how often the TAL could be identified during primary THA and its accuracy as a guide for acetabular component positioning.

Methods: In a prospective series of 63 patients (64 hips) undergoing primary THA, two surgeons attempted to identify the TAL and, if it was found, to use it for acetabular component orientation. Patients in whom the TAL was identified served as the study group and the ligament was used for cup orientation in those patients; the remaining patients in whom the ligament could not be identified served as a control group and had free-hand cup positioning. Anteversion was determined by radiographic measurement from true lateral views.

Results: The TAL was identified in only 30 hips (47%) and was more likely to be found in patients who did not have inferior acetabular osteophytes. Acetabular position was not improved using this ligament for reference.

Conclusions: The TAL could not be routinely identified at surgery and when used for cup orientation it was no more accurate for cup positioning than free-hand technique. 

文献出处：Epstein NJ, Woolson ST, Giori NJ. Acetabular component positioning using the transverse acetabular ligament: can you find it and does it help? Clin Orthop Relat Res. 2011 Feb;469(2):412-6. doi: 10.1007/s11999-010-1523-1. PMID: 20737303; PMCID: PMC3018210.