基于X线片的全髋关节置换术前预测髋臼杯假体型号的新方法及其应用  

A new method and its application for predicting acetabular cup prosthesis size before total hip arthroplasty based on X-ray imaging

作　　者：陈宝刚 冀全博 任鹏 倪明 任其逢 张国强 CHEN Baogang;JI Quanbo;REN Peng;NI Ming;REN Qifeng;ZHANG Guoqiang(Department of Orthopaedics,The Second People's Hospital of Henan Province,Zhengzhou 451100,China;Department of Orthopaedics,Chinese People's Liberation Army General Hospital,Beijing 100853,China;Department of Joint Surgery,Qilu Hospital of Shandong University Dezhou Hospital,Dezhou 253000,Shandong,China)

机构地区：[1]河南省第二人民医院骨科,郑州451100 [2]中国人民解放军总医院第一医学中心骨科,北京100853 [3]山东大学齐鲁医院德州医院关节外科,山东德州253000

出　　处：《中华骨与关节外科杂志》2024年第10期873-878,共6页Chinese Journal of Bone and Joint Surgery

基　　金：国家自然科学基金(82272558)。

摘　　要：目的:介绍一种基于X线片的全髋关节置换术(THA)前预测髋臼杯假体型号的新方法。方法:选择2021年6月至2022年3月于中国人民解放军总医院第一医学中心行THA的86例股骨头坏死患者进行回顾性分析。测量所有患者术前标准骨盆正位X线片上的骨盆高度。采用简单随机抽样法抽取同期于该院行THA的45例患者,使用Mako机器人计算机操作系统对其术前髋关节三维CT扫描图像进行处理,建立骨盆的三维立体模型,分别测量骨盆标准0°位、向前倾斜(5°、10°、15°)位和向后倾斜(5°、10°、15°)位的骨盆高度。采用简单线性回归模型分析骨盆高度与髋臼杯外径的关系。计算预测的髋臼杯外径与实际使用的髋臼杯外径的组内相关系数(ICC)。结果:所有86例患者骨盆高度与髋臼杯外径之间存在线性关系,简单线性回归方程为:髋臼杯外径=24.82+(骨盆高度×0.13)(P<0.001)。预测的髋臼杯外径和实际使用的髋臼杯外径的ICC=0.757(P<0.001),可重复性较好。骨盆前、后倾15°内的7个位置测量的骨盆高度差值最大为5.8 mm。结论:术前标准骨盆正位X线片的骨盆高度与实际使用的髋臼杯外径之间存在线性关系,使用术前X线片的骨盆高度预测THA术中实际使用的髋臼杯假体型号是可行的;X线片中骨盆前后倾斜15°以内对使用本方法预测髋臼杯假体型号的影响很小。Objective:To introduce a new method for predicting acetabular cup prosthesis size before total hip arthroplasty(THA)based on X-ray imaging.Methods:A retrospective analysis was conducted on 86 patients with osteonecrosis of the femoral head who underwent THA at the First Medical Center of Chinese People's Liberation Army General Hospital from June 2021 to March 2022.The pelvic height was measured preoperatively from the standard anteroposterior pelvic X-ray imaging of all patients.A simple random sampling method was used to select 45 patients who underwent THA during the same period in the hospital,and the preoperative hip joint three-dimensional CT scan images were processed using the Mako robotic computer operating system to establish a three-dimensional pelvic model.The pelvic height was measured at standard 0°,anteroposterior tilt(5°,10°,15°),and retroverted tilt(5°,10°,15°)angles.A simple linear regression model was used to analyze the relationship between the pelvic height and the outer diameter of the acetabular cup.The intraclass correlation coefficient(ICC)between the predicted and actual outer diameter of the acetabular cup was calculated.Results:A linear relationship was observed between the pelvic height and the outer diameter of the acetabular cup in all 86 patients,and the simple linear regression equation was as follows:outer diameter of the acetabular cup=24.82+(pelvic height×0.13)(P<0.001).The ICC between the predicted and actual outer diameter of the acetabular cup was 0.757(P<0.001),indicating good repeatability.The maximum difference in pelvic height measured at the seven positions within 15°of anteversion and retroversion was 5.8 mm.Conclusions:There is a linear relationship between the preoperative pelvic height on the standard anteroposterior pelvic X-ray imaging and the actual used outer diameter of the acetabular cup.It is feasible to use the pelvic height on preoperative X-ray imaging to predict the actual acetabular cup prosthesis size used in THA.The impact of pelvic anteversio

关 键 词：全髋关节置换术 骨盆高度 髋臼杯 术前规划 

分 类 号：R684[医药卫生—骨科学]