全髋关节置换术后假体周围骨溶解的影像研究

发布时间：2018-05-19 13:20

  本文选题：关节成形术 + 置换　； 参考：《浙江大学》2014年硕士论文

【摘要】：目的 探讨全髋关节置换术(total hip arthplasty,THA)后假体周围骨溶解的影像表现,以提高诊断水平。 方法 回顾性分析经手术和病理证实的全髋关节置换术后假体周围骨溶解的髋关节影像资料,总结其影像特征。24例髋关节均行X线平片检查,其中17例行CT平扫。 结果 (1)病变部位及类型：假体周围骨溶解发生于股骨23例(层型15例,扩张型8例)(95.8%),累及股骨Gruen1～2和6～7区8例(34.8%),Gruen1、7区8例(34.8%),Gruen1-7区6例(26.0%),Gruen2-3.6区1例(4.3%)；发生于髋臼21例(层型14例,扩张型7例)(87.5%),累及髋臼Delee Ⅰ～Ⅲ区14例(66.7%),Delee Ⅰ.Ⅲ区4例(19.0%),DeleeⅡ～Ⅲ区2例(9.5%),Delee Ⅰ～Ⅱ区1例(4.8%)。 (2)病灶表现：病变区骨皮质不规则变薄24例(100%),灶状不连续18例(75.0%),局部消失16例(66.7%),伴小骨碎片10例(41.7%)。邻近骨皮质局限性增厚3例(12.5%),病灶边缘显示硬化边21例(87.5%),杯口状界面18例(75.0%)。CT平扫的17例中发现软组织肿物16例(94.1%)。 (3)假体改变：发现内衬磨损21例(87.5%)；螺钉旁骨质缺损11例(45.8%),螺钉穿透髋臼内壁3例(12.5%),断裂2例(8.3%),内陷1例(4.2%)；假体周围金属碎屑12例(50.0%) (4)并发症：股骨假体松动19例(79.2%),髋臼假体松动16例(66.7%)；股骨假体周围骨折11例(45.8%),髋臼假体周围骨折5例(20.8%)；股骨假体脱位2例(8.3%) 结论 全髋关节置换术后假体周围发现层型或扩张型骨质缺损,伴边界清晰、密度均匀、有薄包膜的软组织肿物,结合髋臼假体磨损改变,能够对假体周围骨溶解作出准确的影像诊断。
[Abstract]:Purpose To investigate the imaging features of periprosthetic osteolysis after total hip arthroplasty in order to improve the diagnostic level. Method The imaging data of osteolysis around the prosthesis after total hip arthroplasty proved by surgery and pathology were analyzed retrospectively. The imaging features of the hip joints were summarized. All the 24 cases of hip joints were examined by X-ray plain film, of which 17 cases were performed plain CT scan. Result (1) location and type of lesion: osteolysis around the prosthesis occurred in 23 cases of femur (15 cases of lamellar type, 8 cases of dilated type, 8 cases of involvement of Gruen1~2 of femur and 8 cases of Gruen1 ~ (1 / 7) area of the femur, 8 cases of Gruen1-7 region of 34.8N, 6 cases of Gruen2-3.6 region, 1 case of 4.3T), 21 cases of acetabular involvement (14 cases of laminar type, 14 cases of laminar type, 8 cases of Gruen1-7 region), 21 cases of acetabular type (14 cases of laminar type, 14 cases of laminar type). Of the 7 cases of dilated type, 14 cases were involved in acetabular Delee 鈪，

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