全髋关节置换后不同体位摄片髋臼角度的变化

唐智，男，1991年生，

汉族，硕士，主要从事关节外科研究。 通讯作者：桂斌捷，副主任医师，硕士生导师，安徽医科大学第一附属医院骨科，安徽省合肥市 230022

中图分类号:R318 文献标识码:A 文章编号:2095-4344 (2016)26-03817-06 稿件接受：2016-04-13

全髋关节置换后不同体位摄片髋臼角度的变化

唐 智，桂斌捷，丁 楠，荣根祥，高 杰，王斯晟(安徽医科大学第一附属医院骨科，安徽省合肥市 230022) 引用本文：唐智，桂斌捷，丁楠，荣根祥，高杰，王斯晟. 全髋关节置换后不同体位摄片髋臼角度的变化[J].中国

组织工程研究，2016，20(26):3817-3822.

DOI: ORCID: 0000-0003-4808-148X(桂斌捷) 文章快速阅读：

文题释义：

人工髋关节置换：是指用生物相容性和机械性能良好的金属材料制成的一种类似人体骨关节的假体，利用手术方法将人工关节置换破坏的关节面，其目的是切除病灶，清除疼痛，恢复关节的活动与原有的功能。人工关节置换具有关节活动较好，可早期下地活动，减少老年患者长期卧床的并发症等优点。 髋臼角度：正常的人体髋臼窝近似于半球凹形，约4/5股骨头在臼内，臼底面朝向前下外形成一定的角度，髋臼外展角的定义即髋臼前缘与水平面，约成45°角；髋臼底面轴心线与躯干冠状面的夹角，称为前倾角，具体正常角的度数国外报道平均为17°。 摘要

背景：在人工全髋关节置换中，髋臼假体放置角度是否合适对手术临床疗效有着重要意义。

目的：研究人工全髋关节置换后患者不同体位髋臼假体外展角及前倾角变化及其相关影响因素。 方法：选择35例全髋关节置换后患者，其中男21例，女14例，年龄51-75岁，同一患者进行不同体位的X 射线检查，分别为站立位骨盆前后位、站立位骨盆侧位片及卧位骨盆前后位X 射线检查，测量髋臼假体外展角、前倾角等相关角度。

结果与结论：①患者站立位的髋臼假体外展角、前倾角高于卧位°，°；°，°，P < ；②前倾角改变主要与患者骨盆入射角、骨盆倾斜角相关；外展角的改变主要与患者骨盆歪斜角相关；③将髋臼假体外展角(40±10)°、前倾角(15±10)°的角度范围定义为安全区间；④结果表明：全髋关节置换后，站立位与卧位骨盆前后位摄片髋臼假体前倾角及外展角都有一定程度的改变，髋臼角度大小与患者骨盆歪斜角、骨盆入射角、骨盆倾斜角有关。 关键词：

骨科植入物；人工假体；人工全髋关节置换；髋臼；前倾角；外展角；脱位

主题词：

假体和植入物；关节成形术，置换，髋；组织工程

Changes of acetabular angle at different positions after total hip arthroplasty

Tang Zhi, Gui Bin-jie, Ding Nan, Rong Gen-xiang, Gao Jie, Wang Si-sheng (Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China)

Abstract

BACKGROUND: During total hip arthroplasty, placement angle of acetabular prosthesis is significant for clinical curative effects.

OBJECTIVE: To investigate the abduction angle and anteversion angle of acetabular prosthesis at different positions during total hip arthroplasty and related influential factors. METHODS: Thirty-five patients undergoing total hip arthroplasty were included in this study, containing 21 males and 14 females, at the age of 51-75 years old. The same patient at different positions underwent X-ray examination, including standing anteroposterior pelvis radiographic imaging, standing lateral radiographic imaging and supine anteroposterior pelvis radiographic imaging. Abduction angle and anteversion angle of acetabular prosthesis were measured.

RESULTS AND CONCLUSION: (1) Abduction angle and anteversion angle at standing position were bigger than that at supine position °, °; °, °; P < . (2) The change in anteversion angle was associated with pelvic incidence angle and pelvic tilt angle. The change in abduction angle was associated with pelvic obliq uity. (3) The range of abduction angle (40±10)° and anteversion angle (15±10)° of acetabular prosthesis was identified as security zone. (4) Results suggested that there were changes

全髋关节置换后髋臼角度的X 射线测量 椭圆长轴与双侧坐骨结节连线之

间的夹角，即为髋臼假体外展角

人工全髋关节置换后摄片时，髋臼假体开口在双髋关节前后位摄片中投影为一椭圆，假定椭圆最大值径D 的1/5 D 处为M 点，过M 点作椭圆最大直径D 的垂直线，p 为经M 点的直线与髋臼底边的交点之间的距离，前倾角θ=arcsin p/