Reducing variation in hip replacement outcomes: understanding psoas tendon impingement

减少髋关节置换结果的差异：了解腰肌腱撞击

• 批准号: 2747071
• 金额: --
• 依托单位: University of Leeds
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2747071
• 关键词: Reducing; variation; hip; replacement; outcomes

Total hip replacement (THR) is a successful operation but the number of devices requiring revision is continuing to rise. Up to 40% of patients report persistent pain after their surgery, and a cause is soft tissue impinging (specifically the iliopsoas tendon) against the replaced joint which can occur in around 5% of cases. Effective treatment is usually further surgery, consisting of release or resection of the iliopsoas tendon, alone or in combination with re-positioning the hip replacement cup to reduce the impingement. Some evidence suggests that there is a link between cup size and position, an individual patient's bony anatomy and posture, and symptomatic psoas impingement.The aims of this study are to determine how an acetabular component can be positioned to avoid psoas impingement, given the anatomy and posture of an individual.This project is co-funded by a major implant manufacturer, and will address an issue of relevance to both clinicians and industry to ensure the outcomes of hip replacement surgery for all patients are optimal. Additionally, the project will be co-supervised by an orthopaedic surgeon to provide a clinical perspective.The project will involve characterising the relationship between bony and soft tissue anatomy (using cadaveric and imaging facilities) relating to psoas impingement and posture in a range of subjects, then developing a new computational model to define the wrapping path of the psoas tendon for use in predicting impingement. There will be opportunities to compare characterisation and modelling with an existing clinical data set of patients with symptomatic psoas impingement after hip replacement.The project outcomes will provide evidence for surgical recommendations on component selection and position for different patients to avoid psoas impingement.

全髋关节置换术 (THR) 是一项成功的手术，但需要翻修的装置数量仍在持续增加。高达 40% 的患者报告手术后持续疼痛，原因是软组织（特别是髂腰肌腱）撞击替换的关节，这种情况在约 5% 的病例中会发生。有效的治疗通常是进一步的手术，包括单独释放或切除髂腰肌腱，或结合重新定位髋关节置换杯以减少撞击。一些证据表明，罩杯大小和位置、个体患者的骨骼解剖结构和姿势以及症状性腰肌撞击之间存在联系。本研究的目的是确定如何定位髋臼假体以避免腰肌撞击，考虑到解剖结构该项目由一家主要植入物制造商共同资助，将解决与临床医生和行业相关的问题，以确保所有患者的髋关节置换手术效果最佳。此外，该项目将由骨科医生共同监督，以提供临床视角。该项目将涉及表征一系列受试者中与腰肌撞击和姿势相关的骨和软组织解剖学（使用尸体和成像设施）之间的关系，然后开发一个新的计算模型来定义腰肌腱的缠绕路径，用于预测撞击。将有机会将髋关节置换术后有症状的腰肌撞击患者的特征和建模与现有临床数据集进行比较。该项目成果将为不同患者的组件选择和位置的手术建议提供证据，以避免腰肌撞击。