股骨峡部髓腔与全髋置换术中假体选择的关系

Relationship between femoral isthmus and selection of femoral prosthesis in total hip arthroplasty

目的探讨股骨峡部髓腔大小对全髋关节置换术股骨假体选择的影响及意义。方法测量分析初次全髋关节置换术患者影像学资料,采用实验对照方法分析比较峡部髓腔预测股骨假体型号的一致性和准确性。结果峡部髓腔预测型号与实际型号之间存在较高符合率(80%)和良好相关性(r=0.77),两组数据之间无明显差异(P=0.083>0.05)。实验组与对照组预测假体型号之间无明显差异(P=0.14>0.05)。结论峡部髓腔大小与股骨假体选择之间存在密切联系。利用峡部髓腔预测股骨假体型号可以作为假体型号选择的重要参考。

Objective To evaluate relationship between the intramedullary dimension of femoral isthmus and the selection of femoral component in total hip arthroplasty. Methods Twenty patients （ age range 30 - 76 years, mean age 55.4 years） undertaking primary total hip arthroplasty were included. Prediction to select a stem was based on the intramedullary dimension of isthmus accurately measured from preoperative radiograph. Conventional preoperative templating served as control. Paired t test was adopted for statistical analysis. Resuits Among the 80% cases, the results of isthmus-method were satisfactory. Dimensions of the isthmus correlated fairly well with sizes of the stems （ r = 0. 77）. There was not stastistically significant difference between the isthmus-predicted sizes and the actual sizes （ P =0. 083 〉0. 05 ） and the sizes of control （ P =0. 14 〉0. 05）. Conclusion Isthmus is an essential structure to determine the size of femoral component. The dimension of isthmus correlates fairly well with the size of femoral stem. As a measurement to choose the appropriate femoral implant in total hip arthroplasty, the isthmus-method has the similar accuracy as the common templating.