内蒙古地区样本髋关节置换假体位置数字化评估

Digital assessment of prosthesis position in hip replacement in Inner Mongolia

目的测量内蒙古地区髋关节置换术后假体位置参数,了解假体位置分布及解剖重建率。方法纳入内蒙古地区四家三级医院179例髋关节置换术后首次X线资料(年龄30~70岁),影像资料以JEPG格式导入Mimics21.0软件,采用多人重复测量取平均值的方法测量6项参数,包括髋臼假体外展角、前倾角、髋关节旋转中心垂直位置和水平位置、股骨偏心距及双下肢长度差异;比较术侧与健侧髋关节旋转中心位置、股骨头偏心距的差异,统计以上6项参数的解剖重建率。结果观察者间及观察者自身的组内相关系数为0.84~0.99,可靠性较好。健侧股骨头偏心距与术侧差异无统计学意义;术侧髋关节旋转中心垂直位置、水平位置与健侧相比,向内上方偏移,差异存在统计学意义(P<0.05)。髋臼假体外展角、前倾角、髋关节旋转中心垂直位置、水平位置、股骨头偏心距及双下肢长度差异的解剖重建率分别为79.90%、77.70%、43.02%、60.34%、60.30%、79.30%。结论本研究统计内蒙古地区髋关节置换术假体位置的分布情况,认为术后较难达到完全的解剖重建,其中髋关节旋转中心垂直位置、水平位置及股骨偏心距的解剖重建率偏低,需改进手术方法缩小两侧的差异。

Objective To measure the position parameters of the prosthesis after hip arthroplasty in Inner Mongolia,and to understand the position distribution and anatomical reconstruction rate of the prosthesis in Inner Mongolia.Methods The X-ray data of hip arthroplasty were collected from four tertiary hospitals in Inner Mongolia,aged 30-70 years,and 179 cases were finally.The image data was imported into the Mimics 21.0 software in JEPG format measured by multiple people's repeated measurements and taking the average value,including acetabular prosthesis abduction angle,anteversion angle,hip rotation center position(vertical position,horizontal position),femoral offset,and leg length discrepancy,and the differences in the center of rotation of the hip joint and femoral offset between the operated side and the healthy side were compared,and the anatomical reconstruction rates of the above 6 parameters were counted.Results(1) The inter-observer and intra-observer correlation coefficients ranged from 0.84 to 0.99,showing good reliability.(2) There was no statistically significant difference in the femoral offset on the healthy side and the operated side,but there were statistically significant differences in the vertical position and horizontal position of the hip joint rotation center between the operated side and the healthy side(P<0.05),and compared with the healthy side,the center of rotation of the prosthesis on the operated side is shifted inwardly and upwardly.(3)The anatomical reconstruction rates of acetabular prosthesis abduction angle,anteversion angle,hip joint rotation center vertical position,horizontal position,femoral offset,and the leg length discrepancy were79.90%,77.70%,43.02%,and 60.34%,60.30%,79.30%,respectively.Conclusions This study understands the distribution of prosthetic positions in hip arthroplasty in Inner Mongolia.It is difficult to achieve completely anatomical reconstruction after surgery.Among them,the anatomical reconstruction rate of the vertical position,horizontal position of the hip joint rotation center and femoral offset is low.Surgical methods need to be continuously improved to further narrow the difference between the two sides.