数字化模板测量在选择髋关节假体中的应用

Using digital templating to predict the size of prosthesis in total hip arthroplasty

目的探讨采用数字化模板测量方法选择人工髋关节假体的应用效果。方法选取2005年1月至2007年2月的122例患者（132髋），男68例，女54例；年龄35-82岁，平均62．4岁。应用医院数字化影像网络系统和数字化模板在计算机上进行全髋关节置换术前模板测量。由手术医生组和影像科医生组分别进行数字化模板测量，预测手术中所需假体型号的大小，并与手术中实际应用的假体型号进行比较。结果手术医生组髋臼假体型号与股骨假体型号手术前后测量差异无统计学意义（Z=0．4531，P=0．6505；Z=0．5452，P=0．5856）。手术医生组术前预测髋臼假体型号与股骨假体型号同术中应用的假体型号之间存在相关性（r=0．9361，P=0．0068；r=0．9435，P=0．0087）。影像科医生组髋臼假体型号与股骨假体型号手术前后测量比较差异无统计学意义（Z=0．6834，P=0．4934；Z=0．1027，P=0．8990）。影像科医生组术前预测髋臼假体型号、股骨假体型号同术中应用髋臼假体型号、股骨假体型号之间存在相关性（r=0．9214，P=0．0051；r=0．9357，P=0．0072）。应用数字化模板测量选择的假体型号与术中实际应用假体型号相比较，髋臼假体的准确率达71．59％，股骨假体准确率达78．04％。结论应用数字化模板测量进行术前设计，选择人工全髋关节置换的假体具有较高的准确率和可信度。

Objective To evaluate application of the measurement methods of digital templates to select an hip prosthesis. Methods From January 2005 to February 2007, 122 patients （132 hips）, including 68 males and 54 females, were studied. The hospital network system of digital imaging and digital templates on the computer were applied in preoperative template measurement of total hip replacement. For the surgeon group and radiologist group, digital template measurements were used to predict the required size of models, and to compared with the actual prosthesis used in the operation. Results Surgeon group acetabular prosthesis model and femoral prosthesis model before and after surgery were no significant difference between measurements （Z=0.4531, P=0.6505; Z=0.5452, P=0.5856）. Surgeon predicted preoperative acetabular prosthesis model with intraoperative acetabular prosthesis significant correlation between the models （r= 0.9361, P=0.0068）, preoperative surgeon predict femoral prosthesis model with intraoperative application of femoral prosthesis significant con＇elation between the models （r=0.9435, P=0.0087）. Acetabular prosthesis model and femoral prosthesis model of radiologist group, before and after surgery, were no difference between measurements （Z=0.6834, P=0.4934; Z=0.1027, P=0.8990）. Radiologist preoperative prediction model of acetabular prosthesis with intraoperative acetabular prosthesis significant correlation between the models （r= 0.9214, P=0.0051）, preoperative radiologist prediction model with the femoral prosthesis surgery Application of femoral prosthesis significant correlation between type （r=0.9357, P=0.0072）. Total hip arthroplasty using the digital measurement of choice prosthesis template model and the practical application of prosthesis surgery, models, compared acetabular prosthesis accuracy rate of 71.59%, femoral prosthesis 78.04% accura- cy rate. Conclusion The measurement of preoperative digital template design, selection of artificial total hip replacement prosthesis with high accuracy and credibility.