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非骨水泥型全髋置换术中股骨假体前倾角的医生估测值与CT测量值的比较 被引量:3

A Comparison of Surgeon Estimation and Computed Tomographic Measurement of Femoral Component Anteversion in Cementless Total Hip Arthroplasty
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摘要 背景:全髋关节置换股骨假体前倾角的术中估测,通常由手术医生通过假体柄和股骨髁平面的相对关系进行肉眼观察。目前,普遍认为前倾角范围应在10°-20°,但是我们怀疑在非骨水泥型股骨假体植入过程中始终保持前倾角在该范围内比想像的更困难。方法:我们前瞻性评估了109髋(99例患者)全髋置换手术股骨假体前倾角的准确度,这些病例中股骨假体植入没有应用骨水泥。术后我们通过股骨远端髁上和后髁确定股骨干平面,使用股骨CT三维重建测量股骨柄前倾角。然后计算偏倚和测量精度。结果:手术医生对股骨假体柄前倾角估测的平均值(和标准差)为9.6°±7.2°(范围,-8°-28°),CT测量的股骨柄前倾角的平均值为10.2°±7.5°(范围,-8.6°~27.1°)(p=0.324)。手术医生估测值与CT测量值之间的相关系数是0.688,组内相关系数为0.801。通过CT测量的前倾角中,49例(45%)前倾角在10°~20°,43例(39%)前倾角在0°~9°,8例(7%)前倾角〉20°,9例(8%)出现后倾。结论:手术医生对非骨水泥型股骨柄前倾角估测的精确度较差,常没有在预定的10°~20°。该发现更加证实通过评估股骨柄和臼杯的联合前倾角以获得安全活动范围的重要性。
出处 《中华骨科杂志》 CAS CSCD 北大核心 2010年第3期I0001-I0006,共6页 Chinese Journal of Orthopaedics
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