新型角度测量器在全髋关节置换术中的应用

Application of a new angular gauge in total hip arthroplasty

目的探讨新型角度测量器在全髋关节置换术(THA)中的应用效果。方法对40例行THA治疗的患者按照术中是否使用新型角度测量器置入髋臼臼杯分为测量器组(使用新型角度测量器辅助置入髋臼臼杯行THA治疗,20例)和传统组(传统方法置入髋臼臼杯行THA治疗,20例)。记录两组切口愈合及并发症发生情况。比较术后第2天两组髋臼臼杯外展角、前倾角与术前规划的误差。结果患者均获得随访,时间1~6个月。术后第2天髋臼臼杯外展角、前倾角与术前规划的误差测量器组均明显小于传统组,差异均有统计学意义(P<0.01)。两组切口均一期愈合。除传统组1例出现肌间静脉血栓外,患者均未出现假体脱位、假体松动、深静脉血栓、感染等并发症。结论新型角度测量器结构简单、操作简便,在THA术中不仅能对髋臼锉杆操作方向进行刻度化测量或指引,利于髋臼锉对髋臼的同心圆磨锉,使臼杯与髋臼良好匹配,而且能对臼杯置入后的前倾角和外展角进行刻度化测量,有效减小了术中用肉眼评估的误差。

Objective To investigate the application effect of the new angular gauge in total hip arthroplasty(THA).Methods The 40 patients treated with THA were divided into two groups according to whether the new angle measuring device was used to place the acetabular cup during operation,they were the measuring device group(20 patients were treated with THA assisted by the new angle measuring device)and the traditional group(20 patients were treated with THA assisted by conventional method).The wound healing and complications of the two groups were recorded.At 2 d postoperaiton,the errors of the abduction and anteversion angles of the acetabular cups and the preoprative planning were compared between two groups.Results Patients were followed up for 1~6 months.On the second day after operation,the errors between acetabular cup abduction angle,anteversion angle and preoperative planning in the measuring device group were significantly smaller than those in the traditional group(P<0.01).The incisions in both groups healed in one stage.Except for one case of intermuscular vein thrombosis in the traditional group,the remaining patients did not suffer from complications such as prosthesis dislocation,prosthesis loosening,deep vein thrombosis or infection.Conclusions The new angle measuring device has a simple structure and easy operation,which can not only provide graduated measurement or guidance for the direction of acetabular contusion rod operation during THA,which facilitates the concentric grinding of the contusion rod on the acetabulum and makes the cup match well with the acetabulum,but also provides graduated measurement of the anteversion and abduction angles after the placement of the cup,effectively reducing the errors assessed with the naked eye during the operation.