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Objective: With the popularization and promotion of total hip arthroplasty (total hip arthroplasty, THA), operative technique is improving daily, significantly longer life of the prosthesis after postoperative quality of life has been significantly improved. Bone cement fixed prosthesis or biological fixation prosthesis, after 10 years of excellent rate can reach 90%. However, with the increasing number of patients undergoing follow-up time of total hip arthroplasty extend postoperative complications are more and more attention of scholars. Some patients still appear hip pain and mild activity limitation. Except prosthesis loosening, infection, and other factors, the morphology of the ischial after total hip replacement effect also has important implications. In clinical work, we found that the different forms of the ischial can affect the distance between the ischial small rotor and femur, may also cause the impact between the two squeeze or soft tissue, resulting in pain thereby affecting the stability of the hip joint surgery. This point has not yet attracted the attention of orthopedic surgeons. By consulting the relevant literature, we have not yet found the ischial morphology of total hip arthroplasty effects reported. In this study, by measuring the the ischial body sagittal axis angle and cadavers in the neutral position, the extension of 15 °, 30 ° extension three body postures femur small rotor with the distance of the ischial tuberosity, analysis people ischial morphology the differences and femur rotor and ischial position relations, to investigate their ischial morphological people total hip arthroplasty and total hip arthroplasty in establishing the eccentricity of the impact of the the femur small rotor with ischial position relationship to the adoption of patients undergoing The first double hip anteroposterior piece guide surgical operation, to reduce postoperative pain caused by impact extrusion or soft tissue, and further improve the quality of life of patients. Method: Determination of of an ischial body and sagittal angle selected from February 2005 to September 2006 Third Hospital of Hebei Medical radiology shot double hip anteroposterior film 200 cases, 114 cases were male, female 86 cases . Selected population age control in more than 18 years old and 41 years old, the average age of men, women average age of 49 years old. Double hip anteroposterior film inclusion criteria for the pelvis without fracture, no deformity, ischial body bone changes, the the coccyx tip is sewn on the edge of the symphysis pubis bone the bilateral obturator symmetrical large. The application Photoshop image editing software, measuring the angle between the the double hip anteroposterior film left and right side of the ischial body with the sagittal axis. Statistical software used SAS8.0 the left and right side of the angle between the men, the women left and right side of the angle between the men and women of the left side of the angle between men and women right side angle difference analysis, respectively. Measurement of the distance between the femoral small rotor with ischial hip postural select Hebei Medical University, Department of Anatomy and Research using adult cadavers 20 cases, 14 cases of male specimens, six cases of female specimens. Cadavers inclusion criteria for the preservation or fixed, pelvis, hip, femur complete, and no fractures, no deformity and lesions. Specimens prone position to place, from the hips back approach to anatomy of the hip, the layer separation of the skin, subcutaneous tissue, muscle, excluding attached to the femur small rotor and the ischial tuberosity muscle and tendon tissue exposed femur small rotor and the ischial tuberosity . The use of my limbs cross joint external fixator in the neutral position, extension the 15 ° postural and after extension 30 ° immobilization of lower extremity vernier caliper to measure the distance between the femur small rotor and the ischial tuberosity three body postures and analyzed statistically. Results: 1 the ischial body and the angle between the sagittal axis: the measured values ??of the the ischial body and sagittal angle normality test, according to a = 0.1 standard, male angle between the left and right side of the ischial body sagittal axis the values ??obey normal distribution (left W = 0.99, P = 0.94 gt; 0.1; right side of W = 0.99, P = 0.83 gt; 0.1). The women left and right side of the ischial body and the angle between the sagittal axis values ??obey normal distribution (left W = 0.98, P = 0.24 gt; 0.1; right side of W = 0.99, P = 0.96 gt; 0.1). 1.1 the left and right side of the the ischial body and sagittal angle comparison of two sample T-test comparison of the measured data, the the male left ischium body of with sagittal angle in degrees mean of 28.38 ° ± 4.77 ° (mean ± standard deviation); the male right ischium body of with sagittal angle in degrees mean of 27.87 ° ± 4.88 ° (mean ± standard deviation), according to a = 0.05, the men left and right ischial body sagittal axis angle difference was not statistically significant (t = 0.80, P gt; 0.05). Women left ischial body and sagittal angle in degrees mean 23.18 ° ± 5.39 ° (mean ± standard deviation); the female right ischium body of with the mean sagittal angle in degrees to 22.90 ° ± 5.91 ° ??(average mean ± standard deviation), according to a = 0.05, women left and right side of the ischial body with sagittal axis angle difference was not statistically significant (t = 0.33, P gt; 0.05). The angle of the the ischial body 1.2 Gender comparison of male and sagittal angle left ischial body and sagittal angle was significantly larger than females on the left, and the difference was statistically significant (t = 7.22, P lt; 0.01); The angle of the the male right ischium body of with sagittal angle was significantly larger than females on the right, and the difference was statistically significant (t = 6.34, P lt; 0.01). The distance between the femoral small rotor with ischial hip different body postures: in the neutral position, the extension of 15 °, 30 ° extension three kinds of different body postures were measured femoral small rotor to the distance between the ischial tuberosity, three posture under the left distance mean 2.04cm, 1.77 cm, 1.60 cm; right side, respectively, of 2.00 cm, 1.80 cm, 1.65 cm. Compatibility group design analysis of variance at a = 0.05 standard, whether on the left or the right side of the distance between the two is in the neutral position, extension 15 °, 30 ° extension of three different body postures differences are statistics significance (left F = 101.98, P lt; 0.01; right side of the F = 120.92, P lt; 0.01). Conclusion: 1 people ischial body and the angle between the sagittal axis there are significant differences between different gender, the female ischial body and sagittal axis angle less than men. 2 with the hip extension angle increases, reduce the distance between the femur small rotor and the ischial tuberosity. If you do not establish appropriate eccentricity total hip arthroplasty, cause the ischial body sagittal angle is too small (the angle between lt; 15 °) of the patients in extension and adduction posture femur small rotor too small, resulting in soft tissue between the two squeezed to cause pain, and may even collide with the distance between the ischial tuberosity. 4 double hip anteroposterior film can determine the initial ischial morphology infer the possibility of femur small rotor ischial tuberosity after collision. Suggesting that we must carefully analyze the preoperative anteroposterior film of both hips accurate templates measurement, to develop careful surgical program, surgery to establish appropriate eccentric distance, avoid postoperative crash, to improve the stability of the hip.
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