全髋关节置换后髋关节内外旋活动范围计算  

Calculation of artificial hip range of internal rotation and external rotation after total hip replacement

作　　者：张振华[1] 刘永涛[1] 赵峰[1] 朱一鹏[1] 

机构地区：[1]济宁医学院附属湖西医院骨科(单县中心医院),山东省单县274300

出　　处：《中国组织工程研究与临床康复》2009年第35期6836-6840,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:全髋关节置换后髋关节内外旋活动范围能否满足日常活动需要直接影响患者对手术的满意度和假体的使用寿命,目前全髋关节置换后髋关节内外旋活动范围及决定因素研究主要集中在临床研究。目的:探讨全髋关节置换后髋关节内外旋活动范围的计算方法。设计、时间及地点:探索性实验,于2008-10在山东省单县中心医院完成。材料:人工髋关节由山东省菏泽恒源医疗器械有限公司提供。方法:用数学方法推导人工髋关节不同臼柄水平截面摆动角的计算公式:绘制臼杯截面分别为半圆,大于半圆,小于半圆的臼柄水平截面示意图。设截面上股骨假体颈柄的宽度2L,臼杯截面开口宽度为2L’,截面所在圆的半径为R。求得臼杯截面大于半圆时摆动角Q=90°-arcsinL/R-arccosL’/R。臼杯截面小于半圆时摆动角Q=90°-arcsinL/R+arccosL’/R。臼杯截面等于半圆时摆动角Q=90°-arcsinL/R。用数学方法推导人工髋关节内旋和外旋时臼柄撞击平面位置的数学表达式:假设臼杯(人工股骨头)的半径为R,股骨假体颈柄的半径为L,股骨假体颈干角减90°为J,臼杯的外展角为B。通过复合函数求导数的方法确定人工髋关节内旋和外旋时臼柄截面摆动角最小值时的截面位置。人工髋关节内旋和外旋时臼柄撞击平面位于旋转中心下方h=(sinJR2-sinBLR)/(R2-L2)/2,其中B∈[0arcsin(sinJL/R)]。随外展角的增大撞击平面逐渐上移至h=sinJ(R2-L2)/2截面,B≥arcsin(sinJL/R)时,撞击平面保持不变均位于h=sinJ(R2-L2)/2平面。推导人工髋关节内旋和外旋活动范围的计算公式。主要观察指标:全髋关节置换后髋关节内外旋活动范围计算公式。果:人工全髋关节置换后髋关节内旋和外旋活动范围ROM=2{90°-arcsin1/(cos2Jk2+sin2J)/2+arcos[((cos2B-sin2J)k2+sin2J)/2/(cosBcos2Jk2+sin2J)/2]},(k=R/L)。结论:全髋关节置换后髋关节关节内外旋活动范围与髋臼杯外展角、�BACKGROUND： The range of internal rotation and external rotation after total hip replacement directly influences the satisfaction and useful life of prosthesis. Currently, the range of rotation and related influential factors has focused on clinical studies. OBJECTIVE： To explore the method to calculate artificial hip range of internal rotation and external rotation after total hip replacement. DESIGN, TIME AND SETTING： Exploration experiment. The study was performed at the Shanxian Central Hospital in October 2008. MATERIALS： Artificial hip was provided by Heze Hengyuan Medical Instrument of Shandong Province. METHODS： The calculating formula of the oscillation angle for the different horizontal acetabulum-stem cross-section of artificial hip joint was obtained by mathematical methods： ① Drawing different horizontal acetabulum-stem cross-section graphs when the acetabular cup horizontal section was semi-circle, more than semi-circle and less than semi-circle. ② Supposing the width of femoral prosthesis stem on the horizontal cross-section was 2L, the width of acetabular cup cross-section opening was 2L’, the radius of circle on the horizontal cross-section was R. ③ Determining the oscillation angle on different acetabular cup horizontal sections： The oscillation angle Q=90°-arcsinL/R when the acetabular cup horizontal section was a semi-circle; The oscillation angle Q=90°-arcsinL/R-arccosL’/R, when the acetabular cup horizontal section was more than semi-circle; The oscillation angle Q=90°-arcsinL/R＋arccosL’/R when the acetabular cup horizontal section was less than semi-circle. The mathematical expression of acetabulum-stem impingement position during internal rotation and external rotation was determined by mathematical methods： ① Supposing the acetabular cup （artificial femoral head） radius was R, femoral prosthesis neck-stem radius was L, femoral prosthesis neck-stem angle minus 90° was J, acetabular cup abduction was B. ② Determining the acetabulum-stem horizontal c

关 键 词：髋关节 置换 内旋 外旋 活动范围 

分 类 号：R318[医药卫生—生物医学工程]