个体化肩关节假体对肱骨近端骨性结构解剖适配性的影像学评价  

Imaging evaluation on adaptability of proximal humeral anatomy after shoulder replacement with individualized shoulder prosthesis

作　　者：施又兴[1] 唐康来[1] 袁成松[1] 陶旭[1] 汪华清[1] 陈波[1] 郭宇鹏[1] 

机构地区：[1]第三军医大学西南医院骨科、全军矫形外科中心、重庆市运动创伤研究所,重庆400038

出　　处：《中华医学杂志》2015年第11期827-831,共5页National Medical Journal of China

基　　金：卫生部行业专项基金（201302007-2）;重庆市科技攻关项目（CSTC,2007AC5012）

摘　　要：目的 探讨个体化肩关节假体对肱骨近端骨性结构的解剖适配性.方法 2013年10至2014年10月,第三军医大学西南医院骨科对12例单侧行个体化肩关节假体置换术后的病例进行影像学测量、分析与评价.对术后患侧肩关节进行X线摄片,测量相关参数包括颈干角（NSA）、前后扭转角（RA）、肱骨头高度（HH）、肱骨头直径（HD）;与健侧对应参数进行统计学分析及评价.结果 所有患者术后肱骨近端参数与健侧相比,患侧术后NSA和RA分别与健侧参数相差＜3°,患侧术后HH与健侧参数相差＜2 mm,患侧术后HD与健侧参数相差＜3 mm.术后患侧与健侧参数进行配对样本t检验,健侧NSA（140.2 ±6.8）°,患侧术后NSA（139.5 ±6.6）°;健侧RA（34.4 ±3.3）°,患侧术后RA（33.8 ±3.1）°;健侧HH（15.3 ±2.1）mm,患侧术后HH（14.6±0.9）mm;健侧HD（42.2±2.8） mm,患侧术后HD（41.8 ±2.3）mm,差异均无统计学意义（均P＞0.05）.结论 个体化肩关节假体实现了肱骨近端核心参数连续可调,置换术后患侧与健侧参数差异无统计学意义,表明个体化肩关节假体对肱骨近端骨性解剖结构适应性好.Objective Modern shoulder prosthesis has evolved through four generations.And the fourth generation technology has a core three-dimensional design of restoring 3D reconstruction of proximal humeral anatomy.Thus a new shoulder prosthesis is developed on the basis of the technology of 3D prosthesis.Assessment of whether shoulder prosthesis can restore individualized reconstruction of proximal humeral anatomy is based on the adaptability of proximal humeral anatomy.To evaluate the adaptability of proximal humeral anatomy through measuring the parameters of proximal humeral anatomy after shoulder replacement with individualized shoulder prosthesis and compare with normal data.Methods The parameters of proximal humeral anatomy were analyzed and evaluated for a total of 12 cases undergoing shoulder replacement with individualized shoulder prosthesis.The relevant anatomical parameters included neck-shaft angle （NSA）,retroversion angle （RA）,humeral head height （HH） and humeral head diameter （HD）.And the anatomical parameters were compared with the data from normal side.Results All underwent shoulder replacement with individualized shoulder prosthesis.The postoperative parameters of proximal humeral anatomy were compared with those of normal side.And the difference of NSA was 〈 3°,RA 〈 3°,HH 〈 3 mm and HD 〈 2 mm.And paired-sample t test was used to study the parameters of proximal humeral anatomy between postoperative and normal side.The normal and postoperative NSA was （140.2 ± 6.8） ° and （139.5 ± 6.6） ° respectively,RA （34.4 ± 3.3） ° and （33.8-3.1）°,HH （15.3 ± 2.1） mm and （14.6 ＋0.9） mm,HW （42.2 ±2.82） mm and （41.8 ±2.33） mm respectively.No significant difference existed between two groups （P 〉 0.05）.Conclusion Individualized shoulder prosthesis has excellent adaptability to shoulder.All core parameters are freely adjustable and specification models may be optimized.With matching tools,individualized shoulder prosthesis improves the accuracy and

关 键 词：肩关节 假体和植入物 肱骨 适配性 

分 类 号：R687.3[医药卫生—骨科学]