智能手机在人工全髋关节置换术中测量髋臼假体植入角度的应用  

USE OF SMARTPHONE IN ACETABULAR COMPONENT ANGLE MEASUREMENT DURING TOTAL HIP ARTHROPLASTY

作　　者：王景[1] 徐瑞[2] 康学文[1] 张海鸿[1] 

机构地区：[1]兰州大学第二医院骨科甘肃省骨关节病重点实验室,兰州730030 [2]兰州大学第二医院放射科,兰州730030

出　　处：《中国修复重建外科杂志》2016年第9期1061-1064,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨利用智能手机角度测量软件在人工全髋关节置换术(total hip arthroplasty,THA)中测量髋臼假体植入角度的准确性以及应用价值。方法 2012年6月-2015年9月,在50例患者THA术中利用智能手机的角度测量软件测定髋臼假体外展角及前倾角。男24例,女26例;年龄37~83岁,平均71岁。左髋22例,右髋28例。关节置换原因:股骨颈骨折34例,股骨头缺血性坏死16例。均排除髋臼发育异常。术后1周摄骨盆正位X线片,利用PACS系统测量髋臼假体外展角及前倾角。采用组内相关系数评估观察者自身测量的可靠性,Mann-Whitney U检验比较术中手机测量及术后PACS系统测量结果差异;定义术后PACS系统测量髋臼假体角度大于手机测量值为+,反之为-,计算术中及术后角度测量误差范围。结果术中手机测量及术后PACS系统测量髋臼前倾角、外展角的组内相关系数为0.84。术中手机测量髋臼假体外展角为(44.02±1.33)°,前倾角为(17.62±2.20)°;术后PACS系统测量髋臼假体外展角为(44.74±4.05)°,前倾角为(17.22±5.57)°;两种方法测量值比较,差异无统计学意义(Z=-1.977,P=0.482;Z=-0.368,P=0.713)。术后PACS系统测量44例髋臼假体角度在安全区范围内;6例前倾角超出安全区范围1~5°,外展角超出安全区范围1~3°。髋臼假体前倾角术中及术后测量前倾角偏差为-21^+10°、外展角为-10^+9°,提示与术后PACS系统测量值比较,术中手机测量髋臼假体前倾角偏大,外展角偏小。结论 THA术中利用智能手机的角度测量软件确定髋臼假体植入前倾角及外展角方便、快捷、准确。Objective To evaluate the accuracy of using smartphone to measure the angle of acetabular component in total hip arthroplasty（THA）. Methods Between June 2012 and September 2015, the acetabular abduction and anteversion angles were measured in 50 patients undergoing THA. There were 24 males and 26 females, aged 37 to 83 years（mean, 71 years）. The left hip was involved in 22 cases and the right hip in 28 cases. Of 50 patients, 34 suffered from fracture of the femoral neck, and 16 suffered from avascular necrosis of the femoral head. Acetabular dysplasia was excluded in all cases. A smartphone was used to measure the acetabular abduction and anteversion angles during operation; standard Picture Archiving and Communication Systems（PACS） was used to measured the acetabular abduction and anteversion angles on the X-ray film at 1 week after operation. It was defined as positive that the component angle values by PACS measurement were greater than those by the smartphone measurement, whereas as negative. The two measurement methods were compared, and intra-observer variability was assessed by analyzing the intraclass correlation coefficient（ICC）, the Mann-Whitney U-test was used to analyze difference. Results The ICC was 0.84 in the acetabular component angles by smartphone and PACS measurement methods. The acetabular component abduction angle was（44.02±1.33）° and the anteversion angle was（17.62±2.20）° by smartphone measurement. The acetabular component abduction angle was（44.74±4.05）° and the anteversion angle was（17.22±5.57）° by PACS measurement. There was no significant difference between two measurement methods（Z= —1.977, P=0.482; Z= —0.368, P=0.713）. The acetabular component angle was in the safe zone in 44 cases; and the acetabular component anteversion angle was beyond safe range of 1 to 5°, and the abduction angle was beyond safe range of 1 to 3° in 6 cases. Intrameasurement variability was —21 to ＋10° for the anteversion angle and —10 to ＋ 9° for the ab

关 键 词：人工全髋关节置换术 髋臼假体 智能手机 前倾角 外展角 

分 类 号：R687.4[医药卫生—骨科学]