Preoperative Planning for Socket Total Hip Arthroplasty

In cases of dysplastic hip coxarthrosis that require total arthroplasty,the size and positioning of the socket are the most important factors to consider in order to decrease the incidence of operative failure due to mechanical loosening. For this purpose,the author did preoperative socket positioning planning.From the plain X-rays and computed tomograms,the allowable area for socket positioning is calculated. Socket size is determined by the distance from the anterior to the posterior wall of the acetabular osseous dome in CT films taken 15-20mm adove the teardrop line. Upper limit of the socket setting may be up to 20mm above the teardrop line on plain X-ray film:medial limit to the medial acetabular wall.and bone grafting of up to 300/0 for coverage of the socket margin. In cases with Sharp angles over 50 degrees,socket setting within the allowable area may be technically difficult at the time of surgery. Aggressive bone grafting may be needed in order to obtain anatomical height. In these cases,the author recommends reaming of the acetabular dome up to the medial wall of the pelvis and to select a larger sized socket.

変形性股関節症

人工股関節置換術

ソケット設置位置