全髋置换术中C臂X光机确定髋臼位相法的临床应用

The clinical application of the acetabular phase method determined by the C-arm X-ray machine in the total hip replacement

目的在全髋关节置换术(THR)中,人工髋关节的稳定性取决于髋臼假体的精确安置。适当的髋臼角度,能够避免发生髋关节脱位以及撞击征和关节过度磨损,进而维持人工关节的活动度和稳定性。方法应用术中C臂X光机移位测量髋臼的前倾角、外展角来确定术中髋臼假体的置入角度,并与手术前后测定的髋臼位相参数和传统髋臼假体定位器置入假体的患者全髋术后的髋臼位相参数对比,探讨这种测定方法的应用价值。结果髋臼杯的精确安置可以使髋关节的生物力学得以优化,减少髋关节的脱位率和避免撞击。结论术中准确的纠正骨盆的前后倾斜、内外旋转和外展内收,以及髋臼杯的精确安放,可以提高假体置换术手术质量,减少术后脱位、假体撞击、关节活动受限以及聚乙烯磨损等并发症,促使人工关节的保存率得以延长。

Objective In the total hip replacement, the stability of the artificial hip joint depends on the precise replacement of the acetabular prosthesis. The appropriate acetabular angle can avoid dislocation , impact as well as exces-sive wear of the hip joint. And then it helps maintain the mobility and the stability of the artificial hip joint. Methods Dur-ing the practical surgery, the C-arm X-ray machine was used to measure the anteversion and the abduction angle size of the acetabular to determine the displacement angle of the artificial hip joint. Then , the acetabular phase parameters measured before and after the surgery were compared with that of the traditional surgery. The application value of this measurement was explored through the comparison. Results The precise displacement of the acetabular cup could optimize the biomechanics of the hip joint. It could also lessen the dislocation rate and avoid impact of the hip joint. Conclusion In the operation, if the front and rear tilt, the internal and external rotation as well as the abduction adduction of the hip joint are precisely corrected, and if the acetabular cup is accurately displaced, they can improve the quality of the prosthetic arthroplasty. They can help reduce the postoperative dislocation , prosthesis impact, joint motion limitation, polyethylene wear and other complications. They prolong the saving rate of the artificial joint.