全髋关节置换术两种髋臼假体定位方法的CT评价

发布时间：2018-01-20 07:58

本文关键词： 全髋关节置换髋臼横韧带髋臼定位器前倾角外展角　出处：《福建中医药大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：测量两种髋臼杯安装的定位方法(参照髋臼横韧带与使用髋臼定位器)的术后CT上髋臼角度,比较何种结果更接近髋臼角度理想值(外展45°前倾15°),从而为临床实践提供理论依据。方法：收集我院2013年1月至2015年3月行人工全髋关节置换术的病例共60例。其中,男性29例,女性31例；年龄55-75岁,平均为65.2岁；体质指数(Body Mass Index, BMI)平均为25.97Kg/m2。包括髋关节骨性关节炎30例,股骨头坏死10例,股骨颈骨折(按Garden分型法均为Ⅳ型)8例,类风湿性关节炎6例,强直性脊柱炎累及髋关节6例,随机化分为：A组即参照髋臼横韧带定位髋臼假体30例；B组即利用髋臼定位器安装髋臼假体30例。从年龄、性别、BMI及Hariss评分方面对照比较两组是否存在差异。本研究以外展角45°,前倾角15°作为理想标准,运用三维CT测量术后髋臼杯的外展角和前倾角,评价哪组髋臼角度更接近理想值。对获得的数据采用SPSS18.0统计软件包进行相关分析及处理。结果：两组病例在年龄、性别、BMI及Hariss评分方面比较,差异无统计学意义(P0.05),两组具有可比性。CT显示所有假体均获得理想的骨性固定,无1例假体松动。A组术后的外展角平均能44.97±2.99°,B组术后的外展角平均51.80±5.08°,两组比较差异有统计学意义(P0.05)。A组的前倾角平均15.13±2.73°,B组的前倾角平均18.13±4.88°,两组比较差异有统计学意义(P0.05),说明A组更接近髋臼角度理想值。结论：参照髋臼横韧带定位髋臼假体安装比使用髋臼定位器,术后CT上测量髋臼前倾角、外展角更接近理想值,定位方法更简单、准确、可靠。
[Abstract]:Objective: to measure the acetabular angle on CT of two kinds of acetabular cup fixing methods (referring to acetabular transverse ligament and using acetabular locator). The results were closer to the ideal value of acetabular angle (abduction 45 掳forward 15 掳). Methods: from January 2013 to March 2015, 60 cases of total hip arthroplasty were collected, including 29 males and 31 females. Age 55-75 years, average 65.2 years; The average body Mass index (BMI) was 25.97 kg / m2. There were 30 cases of hip osteoarthritis and 10 cases of osteonecrosis of femoral head. There were 8 cases of femoral neck fracture (according to Garden classification), 6 cases of rheumatoid arthritis and 6 cases of ankylosing spondylitis involving hip joint. 30 cases of acetabular prosthesis were randomly divided into two groups: group A: 30 cases were located according to transverse acetabular ligament; There were 30 cases of acetabular prosthesis installed with acetabular locator in group B. there were differences in age, sex and Hariss score between the two groups. The abduction angle of this study was 45 掳. The abduction angle and anteversion angle of acetabular cup were measured by 3D CT with 15 掳anteversion angle as the ideal standard. To evaluate which group of acetabular angle is closer to the ideal value. The data obtained were analyzed and processed by SPSS18.0 statistical software package. Results: two groups of patients in age and sex. There was no significant difference in BMI and Hariss scores between the two groups (P 0.05). The average abduction angle of group A was 44.97 卤2.99 掳and that of group B was 51.80 卤5.08 掳. The difference between the two groups was statistically significant. The average antegrade angle of group A was 15.13 卤2.73 掳and that of group B was 18.13 卤4.88 掳. The difference between the two groups was statistically significant (P 0.05), indicating that group A was closer to the ideal value of acetabular angle. Conclusion: according to the acetabular transverse ligament location, the acetabular prosthesis installation is better than the use of acetabular locator. After operation, the acetabular anteversion angle was measured on CT, the abduction angle was closer to the ideal value, and the localization method was simpler, more accurate and more reliable.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.42

【参考文献】