应用双髋关节正位X线片评估全髋关节置换术后髋臼前倾角  

Evaluation of acetabular anteversion after total hip arthroplasty

作　　者：刘璞 吴厦 高宏 娄佳旺 张威 蔡谞 LIU Pu;WU Sha;GAO Hong;LOU Jia-wang;ZHANG Wei;CAI Xu(Beijing Tsinghua Changgung Hopital,Beijing 102218,China)

机构地区：[1]北京王府中西医结合医院骨伤科,北京102209 [2]北京美德瑞骨科医生集团,北京102200 [3]北京红十字会和平骨科医院骨科,北京100161 [4]清华大学附属北京清华长庚医院骨科,北京102218

出　　处：《中国骨伤》2022年第4期342-345,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨是否可以在普通双髋关节正位X线片上评估髋臼假体前倾角。方法:2019年3月至7月收治全髋关节置换术后患者32例(共41髋),男18例,女14例,年龄(66.2±4.1)岁,所有患者于术后完成双髋关节正位X线片及骨盆CT平扫。通过骨盆CT平扫测量髋臼前倾角,在X线片上采用Saka等测量公式进行测量。结果:41髋X线片测量髋臼前倾角为(16.2±5.0)°,与CT测量的髋臼前倾角(31.8±9.7)°间差异有统计学意义(P=0.00)。此外,X线片测量与CT测量的髋臼前倾角具有明显相关性(Pearson相关系数r=0.84,P=0.00)。结论:CT可以较准确地测得髋臼前倾角,但是其存在辐射量大、成本较高、假体CT伪影重等明显弊端。在普通双髋关节正位X线片上采用Saka测量公式虽然无法像CT测量一样直接获得准确的髋臼前倾角,但却和CT测得的髋臼前倾角间存在高度的相关性,所以提出的方法也可以初步评估髋臼前倾角。Objective:To investigate whether the anteversion angle of acetabular prosthesis can be evaluated on the anteroposterior X-ray film of common double hip joint.Methods:Total 32 patients(41 hips)after total hip arthroplasty were selected,including 18 males and 14 females,aged(66.2±4.1)years.All patients completed the positive X-ray film of both hips and plain CT scan of pelvis after operation.Acetabular anteversion was measured by plain CT scan of pelvis,and measured by Saka and other measurement formulas on X-ray film.Results:The acetabular anteversion measured by X-ray film was(16.2±5.0)°and that measured by CT was(31.8±9.7)°(P=0.00).In addition,there was a significant linear correlation between X-ray film and CT(Pearson correlation coefficient(r=0.84,P=0.00).Conclusion:CT can accurately measure the acetabular anteversion,but it has obvious disadvantages,such as large radiation,high cost,phantom CT artifact and so on.Although Saka measurement formula can not directly obtain the accurate acetabular anteversion as CT measurement,it has a high correlation with the acetabular anteversion measured by CT.Therefore,the method proposed in this study can also preliminarily evaluate the acetabular anteversion.

关 键 词：髋臼 前倾角 影像学 关节成形术 置换 髋 

分 类 号：R683.42[医药卫生—骨科学]