全髋关节置换术中臼杯外展角的影像学研究 |
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投稿时间:2018-06-23 修订日期:2018-08-16
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期刊信息:《中国骨伤》年,第卷,第期,第-页 |
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中文摘要:目的:通过对全髋关节置换术(THA)后患者双髋正位X线上相关参数的测量,分析各参数间关系,探讨THA中安放髋臼的可靠解剖标志及参考标准,精确控制髋臼外展角。方法:收集整理2016年1月至2017年6月于我科行全髋关节置换的182例患者235髋,经过纳入和排除标准,得128例157髋,其中男性91,女性37,左髋82,右髋75,年龄范围22-78岁,平均年龄为55.1岁。在术后双髋正位X线上测量:外展角(β),髂骨厚度(a),髋臼上缘臼杯置入深度(b),坐骨厚度(c),髋臼下缘臼杯置入深度(d),髋臼磨挫深度(e),并对测量参数进行统计分析。结果:β与b呈正相关(r=0.424,p=0.000),β与d呈负相关(r=-0.407,P=0.000),β与b/a呈正相关(r=0.419,P=0.000),β与d/c呈负相关(r=-0.472,P=0.000),并且β与b/a呈线性相关(t=5.753,P=0.000), β与d/c呈线性相关(t=-6.671,P=0.000)。结论:1.当髂骨厚度a取均值时,臼杯外缘距髋臼上缘距离 b取值范围为-8.13±15.15mm;当坐骨厚度c取均值时,臼杯外缘距坐骨外缘距离d取值范围为12.53±8.81mm,术中以此为参考将臼杯放置在安全范围,即:40±10°,术中以此为参考将髋臼假体放置在理想位置。当然具体的b和d值需要通过精确的术前测量,并参照本研究得出的线性方程求得。2.术中主要以臼杯外缘距坐骨外缘的距离d来控制外展角,而臼杯外缘距离正常髋臼上缘的距离b可作为参考。 |
【关键词】全髋关节置换 X线测量 外展角 解剖参照 |
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Radiological study of the cup abduction angle during total hip arthroplasty. |
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ABSTRACT Objective: To measure the parameters of the X-rays on the hips after total hip arthroplasty (THA), analyze the relationship between the parameters, and discuss the reliable anatomic landmarks and reference standards for the placement of the acetabulum in the THA. Control acetabular abduction angle. Methods: We collected 235 hips in 182 patients undergoing total hip arthroplasty between January 2016 and June 2017. After inclusion and exclusion criteria, we obtained 128 patients 157 hips, including 91 males and 37 females.Left hip 82,Right hip 75, age range 22-78 years, mean age 55.1 years. The X-rays were measured on the postoperative anteroposterior (AP) pelvis radiograph: abduction angle (β), thickness of ilial(a), acetabular cup insertion depth in the superior portion(b), thickness of ischium (c),acetabular cup insertion depth in the inferior portion(d), acetabular reamed depth (e), and statistical analysis of measurement parameters. Results: There was a positive correlation between β and b (r=0.381, p=0.000), a negative correlation between β and d (r=-0.373, P=0.000), and a positive correlation between β and b/a (r=0.385, P=0.000). There was a negative correlation between β and d/c (r=-0.448, P=0.000), and a linear relationship between β and b/a (t=5.378, P=0.000). a linear relationship between β and d/c (t= -6.448, P=0.000). Conclusion: 1. When the thickness of the ilium(a) is average,the distance between the outer edge of the cup and the rim of the acetabulum in the superior portion(b) is -8.96±16.44mm. When the thickness of the ischium(c) is average,the distance between the outer edge of the cup and the rim of the acetabulum in the inferior portion(d) is 13.33±10.59mm, using this as a reference,the cup can be placed in a safe range.:40±10°. Of course, the specific value of b and d can be calculated though the measurement in preoperative and the linear equations derived from this study.2. The outreach angle is mainly controlled by the distance between the outer edge of the cup and the outer edge of the cup in the inferior portion(d) during the operation. The distance b from the outer edge of the cup can be used as a reference. |
KEY WORDS Total hip arthroplasty X-ray measurement abduction angle anatomical reference |
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