髋关节骨性关节炎患者经髋关节置换术后发生股骨假体冠状面角度误差的原因分析  

Study on causes of angle error of femoral prosthesis on coronal plane in patients with hip osteoarthritis after total hip arthroplasty

作　　者：冯骁 蒋健 王龙 王业华 FENG Xiao;JIANG Jian;WANG Long(Department of Orthopedics,Affiliated Hospital of Xuzhou Medical University,Xuzhou(221000),China)

机构地区：[1]徐州医科大学附属医院骨科,江苏徐州221000

出　　处：《中国中西医结合外科杂志》2023年第2期180-185,共6页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:分析髋关节骨性关节炎患者经全髋关节置换术(THA)后发生股骨假体冠状面角度误差的原因。方法:收集2017年3月—2022年2月于我院诊疗的髋关节骨性关节炎且行THA治疗的122例患者为研究对象。在PACS系统上通过Image-Pro Plus软件测量患者术前和术后的股骨假体外翻角(FPVA)、股骨侧弯角、股骨机械轴外侧角、股骨颈干角、股骨颈长度。依据术后6个月全长片冠状面FPVA分为2组:当FPVA>3°或<-3°时,纳入力线不良组(89例),余33例纳入力线良好组。比较两组患者的一般临床资料及影像学参数。使用多元Logistic回归分析冠状面上预测假体角度误差的影响因素。构建Nomogram预测模型,并对模型进行验证。使用Spearman相关分析FPVA与其他因素间的相关性。结果:股骨机械轴外侧角、股骨颈干角、股骨颈长度和股骨侧弯角均是骨关节炎患者经THA术后发生假体角度误差的影响因素(P<0.05)。冠状面上构建的预测假体角度误差的Nomogram模型的区分度和内部验证结果均较好。FPVA与股骨侧弯角(r=-0.381,P<0.001)、股骨机械轴外侧角(r=-0.519,P<0.001)、股骨颈长度(r=-0.422,P<0.001)呈负相关,与股骨颈干角(r=0.761,P<0.001)呈正相关。结论:股骨机械轴外侧角、股骨颈干角、股骨颈长度和股骨侧弯角对髋关节骨性关节炎患者术后股骨假体冠状面角度影响较大。Objective To investigate the causes of angle error of femoral prosthesis on coronal plane in patients with hip osteoarthritis after total hip arthroplasty.Methods Perspective study,a total of 122 patients with hip osteoarthritis diagnosed and treated in our hospital from March 2017 to February 2022 were collected and treated with THA.The femoral prosthesis valgus angle(FPVA),mechanical lateral distal femoral angle,femoral shaft-neck angle,femur neck length,femoral side bending angle were measured by Image-Pro Plus software on the PACS system before and after operation.According to the coronal FPVA of the full-length film 6 months after operation,the patients were divided into two groups:when FPVA>3°or<-3°,they were included in the poor force line group,otherwise they were included in the good force line group.The general clinical data and imaging parameters of patients in each group were compared.The influencing factors of predicting the angle error of the prosthesis on the coronal plane were obtained by multiple linear regression analysis of variance.Construct the Nomogram prediction model and verify the model.Spearman correlation was used to analyze the correlation between FPVA and other factors.Results Mechanical lateral distal femoral angle,femoral shaft-neck angle,femur neck length,femoral side bending angle were the influencing factors of prosthesis angle error in patients with osteoarthritis after THA.The Nomogram model constructed on the coronal plane to predict the angle error of the prosthesis has good discrimination and internal verification results.FPVA was negatively correlated with lateral bending angle of femur(r=-0.381,P<0.001),lateral angle of mechanical axis of femur(r=-0.519,P<0.001)and length of femoral neck(r=-0.422,P<0.001),but positively correlated with dry angle of femoral neck(r=0.761,P<0.001).Conclusion Mechanical lateral distal femoral angle,femoral shaft-neck angle,femur neck length,femoral side bending angle have great influence on the coronal angle of femoral prosthesis in patients

关 键 词：髋关节骨性关节炎 髋关节置换术 股骨假体角度误差 

分 类 号：R684.3[医药卫生—骨科学]