中华骨科杂志2024,Vol.44Issue(6) :372-380.DOI:10.3760/cma.j.cn121113-20231224-00419

骨盆沿冠状轴旋转对髋臼假体影响的三维动态分析

Three-dimensional dynamic analysis of the effect of pelvic rotation around coronal axis on acetabular prosthesis

杨阳 宋伟福 张云鸽 李欣 薛桂松 王敬博
中华骨科杂志2024,Vol.44Issue(6) :372-380.DOI:10.3760/cma.j.cn121113-20231224-00419

骨盆沿冠状轴旋转对髋臼假体影响的三维动态分析

Three-dimensional dynamic analysis of the effect of pelvic rotation around coronal axis on acetabular prosthesis

杨阳 1宋伟福 2张云鸽 1李欣 1薛桂松 1王敬博1
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作者信息

  • 1. 天津市天津医院髋关节科四病区,天津 300211
  • 2. 广西壮族自治区贵港市人民医院骨科,贵港 537100
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摘要

目的 探讨骨盆沿冠状轴旋转对全髋关节置换术后髋臼假体安放角度的影响规律.方法 根据Murary的定义将髋臼轴与矢状面成角定义为髋臼外展角,髋臼轴与冠状面成角定义为前倾角,利用数学软件GeoGebra建立简易数学立体几何模型,模拟沿冠状轴旋转时髋臼假体的动态变化,推导出髋臼假体前倾角和外展角动态变化的计算公式.采用MatLab软件绘制骨盆前倾角和外展角的函数图并分析髋臼假体的变化规律.结果 骨盆沿冠状轴旋转时髋臼前倾角和外展角的动态变化与骨盆前后倾斜度存在函数相关关系,而非线性相关的关系.当骨盆沿冠状轴旋转时前倾角公式为α1=arcsin(sinβ1×cosα×cosθ+cosβ1×sinα);髋臼轴朝下时外展角公式为 θ1=arccot(cosβ1×cotθ-sinβ1×tanα/sinθ);髋臼轴朝上时外展角公式为θ1=π-abs[arccot(cosβ1×cotθ-sinβ1×tanα/sinθ)],α为髋臼初始前倾角,θ为髋臼初始外展角,α1为骨盆旋转后髋臼假体前倾角,θ1为骨盆旋转后髋臼假体外展角,β1为骨盆沿冠状轴旋转角.骨盆后倾时髋臼假体前倾角先增后减,外展角持续增大,骨盆前倾时外展角先减后增,前倾角持续减小至负数,前倾角负数时表示髋臼轴朝向后方.结论 当髋臼假体初始前倾角和外展角变化时,前倾角与外展角函数曲线发生相应改变;初始前倾角越大,前倾角越快达到峰值,峰值越大,外展角变化趋势越快;初始外展角越大,前倾角与外展角的变化趋势越小.

Abstract

Objective To investigate the effect of pelvic rotation around coronal axis on the placement angle of acetabu-lar prosthesis after total hip arthroplasty.Methods According to Murary's definition,the angle between the acetabular axis and the sagittal plane was defined as the acetabular abduction angle,and the angle between the acetabular axis and the coronal plane as the anterior inclination angle.A simple mathematical solid geometry model was established by using the mathematical software GeoGebra to simulate the dynamic changes of the acetabular prosthesis when it rotated around the coronal axis,and the calcula-tion formula of the dynamic changes of the anterior inclination and abduction angle of the acetabular prosthesis was derived.Mat-Lab software was used to generate the function graph of pelvis forward inclination and abduction angle and deduce the motion of acetabular prosthesis.Results The dynamic changes of acetabular tilt angle and abduction angle when the pelvis rotated around the coronal axis were functionally related to the anterior-posterior tilt of the pelvis in a nonlinear pattern.When the pelvis rotates around the coronary axis,the anterior inclination angle formula is α1=arcsin(sinβ1×cosα×cosθ+cosβ1×sinα);When the acetabu-lum axis faces downwards the abduction angle formula is θ1=arccot(cosβ1×cotθ-sinβ1×tanα/sinθ);When the acetabulum axis fac-es upwards the abduction angle formula is θ1=π-abs[arccot(cosβ1×cotθ-sinβ1×tanα/sinθ)]withα being the initial acetabular for-ward angle,θ being the initial acetabular abduction angle,α1 being the forward angle of the acetabular prosthesis after pelvic rota-tion,θ1 being the external expansion angle of the acetabular prosthesis after pelvic rotation and β1 being the rotation angle of the pelvis around the coronal axis.When the pelvis is tilted backward,the anterior inclination angle of the acetabular prosthesis in-creases first and then decreases,and the abduction angle continues to increase.When the pelvis is tilted forward,the abduction an-gle decreases first and then increases,and the anterior inclination angle continues to decrease to negative.Conclusion When the initial anterior inclination angle and abduction angle of acetabular prosthesis change,the curve of anterior inclination and ab-duction angle change accordingly.The larger the initial anterior inclination angle is,the faster it reaches its peak value,and the larger the peak value is,the faster the abduction angle changes.The larger the initial abduction angle is,the slower the initial ante-rior inclination angle and the abduction angle change.

关键词

骨盆/动态/关节成形术,置换,髋/髋臼/前倾角/外展角

Key words

Pelvis/Kinesis/Arthroplasty,replacement,hip/Acetabulum/Front angle/Abduction angle

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基金项目

天津市卫生健康委重点项目(TJWJ2021ZD005)

出版年

2024
中华骨科杂志
中华医学会

中华骨科杂志

CSTPCDCSCD北大核心
影响因子:2.137
ISSN:0253-2352
参考文献量20
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