摘要
[目的]本文研究了文献上7种X线片测量髋臼前倾角的可靠性和准确性,以总结出适合临床应用的测量方法。[方法]对2011年9月20日～10月20在积水潭医院矫形骨科进行初次全髋关节置换的60个病人60例髋关节进行了CT和X线片测量髋臼假体前倾角研究。以CT测量结果为金标准,三位独立的测量者使用7种X线测量方法测量的前倾角结果与CT测量的结果进行了比较以评估各种方法的准确性,并评估了各种测量方法的组内和组间测量的可靠性。[结果]所有7种X线测量方法均有很高的组内和组间测量可靠性。与CT测量结果相比较,Widmer方法和Visser方法是不准确的,其他方法均是准确的。Visser方法与解剖学前倾角有正向强相关性。[结论]7种X线测量髋臼假体前倾角的方法中Lewinneck、Hassan、Ackland、Liaw、和Pradhan方法是可靠和准确的,Wid-mer方法和Visser方法是不准确的,但Visser方法可以用于测量髋臼假体的解剖学前倾角。考虑到测量的准确和计算的简便性,建议临床上采用Lewinneck方法和Liaw方法测量髋臼假体的前倾角。
[ Objective] The aim of this study was to evaluate the accuracy and reliability of seven methods those are repor- ted in literature and to suggest a precise and convenient method for clinical use. [ Method] In 60 consecutive patients with 60 THAs performed between September 20th to October 20th 2011 in our hospital, both CT scan and plain anteroposterior plain radi- graphs were taken. Anteversion of the acetabular component was measured by three independent examiners on plain radiographs using these seven methods. Measurements using 3D CT were used as the gold standard reference to assess the validity of the seven methods. The intra-and interobserver reliabilities of each measurement were also evaluated. [ Result] All measurements on plain anteroposterior radiographs had excellent intra-and interobserver reliability. Measurements made using the methods of Widmer and of Visser were significantly different from the 3D CT measurements （ both P 〈 0. 001 ） , whereas measurements made using the remaining five methods were similar to the CT measurements. Whereas measurements using the method of Visser were strongly correlated with the anatomical anteversion measured on 3 D CT. [ Conclusion ] The methods of Lewinneck, Has- san, Ackland, Liaw and Pradhan are reliable and accurate, whereas the methods of Widmer and Visser are not accurate. But the method of Visser can be used to measure anatomical anteversion on plain anteroposterior radiographs. With regard to validity and convenience for calculation, we recommend the use of the method described by Lewinnek and Liaw for measurement of an- reversion of the acetabular component.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2013年第14期1427-1434,共8页
Orthopedic Journal of China
关键词
髋关节置换
前倾角
X线片
hip arthroplasty, ：anteversion, plain radiograph
