摘要
目的:研究盆下型骨盆倾斜对全髋关节置换术中髋臼假体位置的影响。方法:选取行全髋关节置换术的盆下型骨盆倾斜患者51例,其中髋关节发育不良伴退行性变18例,髋关节置换术后假体无菌性松动4例,股骨头缺血性坏死24例,原发性骨关节炎2例,继发性骨关节炎3例。术前拍摄患者负重直立前后位骨盆X线片测定其骨盆倾斜角,按测得的骨盆倾斜角将盆下型骨盆倾斜分为2型:Ⅰ型为骨盆倾斜于肢体短缩侧,即患侧;Ⅱ型为骨盆倾倾斜于健侧。再根据骨盆倾斜角分为3个亚型:0°～3°为A型;>3°～6°为B型;>6°为C型。术后手术台上全身麻醉下拍摄平卧前后位骨盆X线片,测定患者的髋臼外展角及前倾角。结果:Ⅰ型盆下型骨盆倾斜16例,Ⅱ型盆下型骨盆倾斜35例。术后各亚型组前倾角比较,差异无统计学意义(F=0.190,P=0.965)。术后各亚型组外展角比较,差异有统计学意义(F=2.506,P=0.044),Ⅰ-C型患者术后外展角大于其他亚型(Ⅰ-A:P=0.041;Ⅰ-B:P=0.011;Ⅱ-A:P=0.028;Ⅱ-B:P=0.012;Ⅱ-C:P=0.001),与总体平均外展角相比增加了近8°;其余各组外展角比较,差异无统计学意义(P>0.05)。结论:对于骨盆倾斜于肢体短缩侧,且倾斜角>6°的盆下型骨盆倾斜患者,在行全髋关节置换术时应较正常外展角减少8°植入髋臼假体以达到矫正目的。
Objective：To study the effect of pelvic obliquity under pelvis on the position of acetabulum prosthesis in the total hip arthroplasty （THA）. Methods：Fifty-one selected THA patients with pelvic obliquity under pelvis were composed of 18 cases with hip dysplasia degeneration,4 cases with aseptic loosening of prosthesis after THA,24 cases with avascular necrosis of femoral head,2 cases with primary osteoarthritis and 3 cases with secondary osteoarthritis. The pelvic obliquity angles were measured according to the X-ray photos of anteroposterior pelvis for the weight-bearing patients in upright position. The situations of pelvic obliquity under pelvis were divided into 2 types according to pelvic obliquity angles, and the situations of pelvic obliquity in limb shortening side（ diseased Side）were belonged to type I , while the situations of pelvic obliquity in normal side were belonged to type II. Each type was then divided into 3 subtypes according to pelvic obliquity angles, the angle degrees ranged from 0° to 3 ° were belonged to type A, angle degrees ranged from 3 ° to 6° were belonged to type B and angle degrees more than 6° were belonged to type C. Abduction angles and anteversion angles of acetabulum of the patients were measured according to the X-ray photos of anteroposterior pelvis for the patients in the state of general anesthesia and lying on the operating table after the operation. Results：Sixteen cases with pelvic obliquity under pelvis were found in type I , while the others were found in type II. There was no statistical difference in anteversion angles among the 3 subtypes after the operation（ F = 0. 190,P = 0. 965 ）. There was statistical difference in abduction angles among the 3 subtypes after the operation（ F = 2.506, P = 0. 044）. The abduction angle of type I-C were wider than that of other subtypes （ I-A ： P = 0.041 ; I-B ： P = 0.011 ;II-A ： P = 0.028 ;II-B ： P = 0.012 ;II-C ： P = 0.001 ）, and were wider nearly by 8° than the overall average degrees o
出处
《中医正骨》
2011年第12期12-14,共3页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
关节成形术
置换
髋
骨盆
髋假体
髋臼
Arthroplasty, Replacement, hip
Pelvis
Hip prosthesis
Acetabulum
