全髋关节置换术后髋臼假体外倾角的临床研究

中国临床解剖学杂志 ›› 2012, Vol. 30 ›› Issue (2): 233-236.

全髋关节置换术后髋臼假体外倾角的临床研究

卢伟杰¹，金大地¹，　李之琛²，　陈东峰²，　余楠生²

1．南方医科大学第三附属医院骨科，广州 510630；　2.广州医学院第一附属医院骨外科, 广州 510120

收稿日期:2011-11-23 出版日期:2012-03-25 发布日期:2012-04-17
通讯作者: 金大地，教授，博士生导师，E-mail：nyorthop@163.com E-mail:13902280296@139.com
作者简介:卢伟杰（1966- ），男，广东广州人，主任医师，硕士，主要从事关节外科髋膝关节置换的研究，Tel：（020）83062695

Clinical study of cup abduction angle after total hip arthroplasty

LU Wei-jie¹, JIN Da-di¹, LI Zhi-chen², CHEN Dong-feng²，YU Nan-sheng²

1.Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China; 2. Department of Orthopedics, the First Affiliated Hospital of Guangzhou Medical College , Guangzhou 510630, China

Received:2011-11-23 Online:2012-03-25 Published:2012-04-17

摘要/Abstract

摘要：

目的　了解广医一院人工全髋关节置换术后髋臼假体外倾角的情况及外倾角大小与聚乙烯磨损的关系。方法　选取2011年5月前广医一院骨外科THA术后126例145髋患者骨盆前后位X线片，其中男47例，女79例，年龄23~85岁，末次随访时平均年龄60.1岁。采用DR拍摄骨盆前后位照片，测量髋臼外倾角，统计外倾角≥50°及≥55°的发生率。对单侧全髋关节置换患者测量股骨头中心位移，评估髋臼外倾角与聚乙烯磨损的相关性，使用时间超过5年的内衬的线性磨损值与使用时间少于5年的内衬比较有无差异。结果　126例145髋中61个髋的外倾角大于等于50°，百分率为42.1%（34.1%　~50.1%），大于等于55°者32个，百分率为22.1%(15.3%~28.9%)。外倾角<50°组聚乙烯线性磨损比外倾角≥50°组轻，差异有统计学意义，P<0.001，对107个髋的髋臼外倾角与聚乙烯线性磨损值做散点图及简单线性回归分析，二次多项式曲线拟合效果较好，拟合优度（R Square）为0.697，聚乙烯线性磨损值与髋臼外倾角同向相关，回归方程为■=4.431-0.21x+0.003x2。结论　人工全髋关节置换术后髋臼外倾角与聚乙烯线性磨损相关，手术中需要采取有效措施防止髋臼假体外倾角过大。

关键词: 关节成形术, 置换, 髋, 外倾角, 聚乙烯, 内衬

Abstract:

Objective　To assess cup inclination of THAs by measuring the abduction angle and to find out if the abduction angle relate to polyethylene wear or not.　Methods　Cup abduction angle and polyethylene wear were measured on the X-ray with a series of 145 hips undergone THA before 2011 May. The rates of abduction angle greater than 50 degree and 55 degree were calculated. The relationship between cup abduction angle and polyethylene linear wear was evaluated.　Results　It happened in 32（22.1%, 95% CI: 15.3%~28.9%） hips that abduction angle exceeded 55 degree and 61（42.1%, 95%CI: 34.1%~50.1%） hips'abduction angle greater than 50 degree. Abduction angle that greater than 50 degree significantly caused polyethylene liner wear. In 107 unilateral THA, positive correlation between abduction angle and liner wear was revealed by a scatter diagram and then a curve estimation was taken. R square was up to 0.697 using Quadratic curve. Regression equation was ■=4.431-0.21x+0.003x2.　Conclusions　Incorrect abduction angle may cause polyethylene wear in THA. Measurement should be made to place the cup at appropriate position.

Key words: Arthroplasty,replacement, hip, Abduction, Polyethylene, Liner

中图分类号:

R687.4

卢伟杰, 金大地, 李之琛, 陈东峰, 余楠生. 全髋关节置换术后髋臼假体外倾角的临床研究[J]. 中国临床解剖学杂志, 2012, 30(2): 233-236.

LEI Wei-Jie, JIN Da-De, LI Zhi-Chen, CHEN Dong-Feng, TU Nan-Sheng. Clinical study of cup abduction angle after total hip arthroplasty[J]. Chinese Journal Of Clinical Anatomy, 2012, 30(2): 233-236.

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