关节置换股骨形态学研究
Anatomic studies of hip anatomy, specifically on the femoral side, have shown sex-based anatomic differences。Women tend to have a shorter femoral neck, a thinner femoral shaft, a lower cervicodiaphyseal (CCD) angle, a lower femoral offset, and greater anteversion of the femoral neck (Fig. 1). These differences should be addressed during revision hip surgery in order to restore hip anatomy. In particular, to achieve proper soft-tissue balancing, the femoral offset should be accurately restored. The femoral offset is represented by the perpendicular distance from the center of the femoral head to the long axis of the femur (Fig. 2).McGrory et al.found a correlation between a lack of restoration of femoral offset and abductor muscle weakness and limping. These results depend on hip mechanics, with a fulcrum between body weight and the hip abductors (Fig. 3). The length of the lever arm of the hip abductors is smaller than that of body weight. Therefore, the abductors must generate a force that is larger than body weight to maintain a level pelvis. In contrast, an increase in femoral offset increases the lever arm of the abductors, reducing the force required to balance body weight and thereby reducing the incidence of Trendelenburg gait.关于髋关节形态学研究，特别是股骨形态，发现与性别有关的不同。女性相对于男性其股骨颈短、股骨干细、颈干角小、偏心距小、前倾角大（如图1）。手术医生在行手术时要考虑到这些不同，并注意恢复其解剖形态。特别需要注意的是，为了完全软组织平衡，股骨偏心距应准确恢复。偏心距是股骨头旋转中心到股骨干长轴垂直距离（如图2）。Mc Grory等发现当股骨偏心距不足时与股外展肌力量减弱，这时由于髋关节作用机制导致的（如图3）。当臀外展肌力臂缩短时，臀外展肌产生更加强大力量来平衡身体重量。
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