不同位置髋臼杯修复髋臼发育不良的稳定性  

Stability of the acetabular cup in different positions to repair acetabular dysplasia

作　　者：赵阳 陈世荣[1] Zhao Yang;Chen Shirong(Department of Orthopedics,Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院骨科,重庆市400010

出　　处：《中国组织工程研究》2020年第33期5289-5294,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:在全髋关节置换治疗严重髋臼发育不良的过程中,将髋关节假体臼杯置于真臼位置处还是非真臼位置处仍存在争议。目的:通过数字骨科模拟全髋关节置换过程,分析不同位置髋臼杯的稳定性。方法:收集8例髋臼发育不良(CroweⅢ型)患者的骨盆CT影像成像资料,使用Mimics和Solidworks软件重建患者骨盆和髋臼杯图像,根据患者自身髋臼大小在真臼的位置安装合适的髋臼假体,并以2mm的增量将合适大小的臼杯假体逐级递增上移至20 mm,比较不同高度放置髋臼假体的有效CE角和髋臼杯覆盖率。结果与结论:①当髋臼杯上移至真臼上方14 mm处时,测得的有效CE角最大(28.90±1.31)°,此时对应的髋臼杯直径为(42.00±1.94) mm;与髋臼杯上移至真臼上方16,18,20 mm处测得的有效CE值比较差异无显著性意义(P>0.05),其余组间比较差异有显著性意义(P<0.05);②当髋臼杯上移至真臼上方12 mm时,测得的髋臼杯覆盖率最大(93.16±1.04)%,此时对应的髋臼杯直径为(43.00±1.73) mm,与上移至真臼上方14,16,18mm处测得的髋臼杯覆盖率比较差异无显著性意义(P>0.05),其余组间比较差异有显著性意义(P<0.05);③相关性分析显示,随髋臼杯位置上移,有效CE角与髋臼杯覆盖率变化呈正相关;④结果表明在不使用结构性骨移植的情况下,于全髋关节置换术中通过适当上移旋转中心治疗髋臼发育不良(CroweⅢ)将获得更稳定的髋臼杯。BACKGROUND: In the treatment of severe acetabular dysplasia with total hip arthroplasty, it is still controversial whether the cup of the hip prosthesis should be placed in the true acetabulum or not. OBJECTIVE: To analyze the stability of acetabular cup in different positions by simulating the process of total hip arthroplasty with digital orthopedics. METHODS: Pelvic CT imaging data of eight patients with acetabular dysplasia(Crowe III) were collected. The pelvic and acetabular cups of patients were reconstructed using Mimics and Solidworks software. According to the size of the patient’s own acetabulum, a suitable acetabular prosthesis was installed at the position of the trueacetabulum. The acetabular cup prosthesis was moved up to 20 mm in increments of 2 mm in order to compare the effective CE angle and the coverage of acetabular cup with different heights of acetabulum prosthesis. RESULTS AND CONCLUSION:(1) When the acetabular cup was moved up to 14 mm above the true acetabulum, the maximum effective CE angle was(28.90±1.31)° and the corresponding acetabular cup diameter was(42.00±1.94) mm. There was no significant difference between the effective CE measured at 16, 18 and 20 mm above the true acetabulum(P>0.05);there was significant difference between the other groups(P<0.05).(2) When the acetabular cup was moved up to 12 mm above the true acetabulum, coverage rate of the acetabular cup was highest(93.16±1.04)%. At this time, the corresponding acetabular cup diameter was(43.00±1.73) mm, and there was no significant difference in the coverage rate of the acetabular cup measured at 14, 16, and 18 mm above the true acetabulum(P>0.05);there was significant difference between the other groups(P<0.05).(3) The correlation analysis showed that the effective CE angle was positively correlated with the coverage rate of acetabular cup as the position of acetabular cup moved up.(4) The results showed that the more stable acetabular cup would be obtained in the total hip arthroplasty by appropriately moving up

关 键 词：骨 关节置换 假体 髋臼 髋臼杯 数字骨科 影像 3D 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]