目的 探讨基于X线片准确评估人工全髋关节置换术(total hip arthroplasty,THA)臼杯假体覆盖率(以下简称"杯覆率")的方法,并确定可以用于评估杯覆率的有效参数.方法 基于16例健康骨盆CT三维重建数据,3D打印制备骨盆模型;在此基础上,参照常规THA操作植入髋臼假体.采用改良摄片方式通过旋转C臂X线机测量臼杯假体未被宿主骨覆盖区域长度、宽度,计算杯覆率;统计分析其与基于传统正位X线片测量法以及基于骨盆模型实际测量的杯覆率差异.采用多重线性回归分析改良测量法中,假体未被覆盖区域面积与宽度、长度相关性.结果 传统方法、改良方法以及实际测量的杯覆率分别为78.22％±3.36％、86.74％±3.61％、89.62％±2.62％,差异均有统计学意义(P＜0.05).多重线性回归分析结果显示,宽度、长度均与假体未被覆盖区域面积成正线性关系,回归方程:假体未被覆盖区域面积=-21.192+0.248×宽度+0.140×长度,决定系数R2=0.857,P＜0.001.结论 与传统测量方法相比,改良方法能更准确评估THA杯覆率.其中,假体未被覆盖区域宽度可以作为评估杯覆率的有效参考指标.
Estimation of acetabular cup prosthesis coverage rate in total hip arthroplasty based on X-ray films
Objective To explore the method of accurately estimating the acetabular cup prosthesis coverage rate(hereinafter referred to as"cup coverage rate")in total hip arthroplasty(THA)based on X-ray films,and to determine the effective parameters that can be used to estimate the cup coverage rate.Methods The three-dimensional printed pelvic models were established based on CT data of 16 healthy pelvis,and the acetabular prosthesis were implanted according to conventional THA procedure.The length and width of the uncovered area of the acetabular cup prosthesis were measured by a modified X-ray recording method with a rotating C-arm X-ray machine,and the cup coverage rate was calculated.Then the differences among the traditional anteroposterior X-ray recording method,the modified method,and actual measurement on pelvic model were statistically analyzed.The correlation between the area of the uncovered area of the prosthesis and its width and length was analyzed by using multiple linear regression analysis.Results The cup coverage rates of traditional method,modified method,and actual measurement were 78.22％±3.36％,86.74％±3.61％,and 89.62％±2.62％,respectively,with significant differences(P＜0.05).The results of multiple linear regression analysis showed that the width and length were positively linear with the uncovered area of the prosthesis,and the regression equation was as follows:uncovered area of the prosthesis=-21.192+0.248xwidth+0.140xlength,and the coefficient of determination R2=0.857,P＜0.001.Conclusion Compared with the traditional method,the modified method can more accurately evaluate the cup coverage rate during THA,and the width of the uncovered area of the prosthesis can be used as an effective reference for the cup coverage rate.
万方数据
维普
