不同股骨头颈直径比与髋臼角对人工髋关节活动的影响

The influence of head-neck ratio and implant position on the range of motion after total hip arthroplasty

目的: 探讨不同股骨头颈直径比和髋臼安置方位对人工全髋关节活动范围的影响。方法: 应用计算机模拟技术建立人工全髋关节三维计算机模型, 模拟测试三种不同头颈直径比全髋假体在体外不同安置方位的活动范围。结果: 全髋关节置换术后的活动范围不仅取决于假体设计的某些参数, 如头颈直径比, 还取决于假体安置的某些参数, 如臼杯的外展角和前倾角, 假体柄的前倾角, 以及臼杯和柄的相互方向等等。人工全髋关节在合适的安置方位内产生最佳的活动范围。头颈比越大, 同一安置方位同一方向的活动范围越大。结论: 人工全髋关节相对较大的头颈直径比在合适的安置方位内产生最佳的活动范围, 可减少全髋关节置换术(THA) 后假体撞击机会。国产镁硅玉全髋假体由于头颈比太小, 在任何安置方位内其活动范围都较小, 将难于满足日常生活需要。

Objective: To study the influence of head-neck ratio and implant position on the range of motion(ROM) after total hip arthroplasty(THA).Method:In this study the author established a three-dimensional computerized model of hip joint and tested the range of motion of three different head-neck ratio after total hip arthroplasty.Result:Range of motion after total hip arthroplasty depended on design parameters such as head-neck ratio,but also on the implantation parameters such as the cup's inclination and antevertion, the stem' s antevertion and their combination of each other.Optimal range of motion requireed compliant position of total hip components.The range of motion increased with the enlarging of head-heck ratio.Conclusion:Higher head-neck ratio leads to optimal range of motion and decreased the prevalence of prosthetic impingement within compliant,well-defined combination of cup's inclination,cup's antevertion and stem's antevertion depending on the intended ROM.Domestic magnesium-silicon jade total hip prosthesis has too low head-neck ratio to result in enough range of motion that fulfilled daily living after total hip arthroplasty.