摘要
背景：假体和股骨近段髓腔横断面的匹配非常重要,模板测量法术前预测股骨假体型号准确率低,因此有必要寻找一种新的方法用于全髋关节置换前预测假体型号。目的：探讨股骨颈内侧径测量法在全髋关节置换前选择股骨假体型号的可行性及准确性。方法：收集58例（65髋）初次非骨水泥全髋关节置换患者的临床资料。在髋关节置换前使用CT测量股骨颈髓腔内侧径,并利用股骨颈髓腔内侧径对比股骨假体型号大小术前选择假体型号,以采用模板测量法为对照。结果与结论：股骨颈髓腔内侧径与各假体系统的假体型号之间都存在着很强的相关性（r=0.84~0.85;P〈0.05）,说明应用股骨颈髓腔内侧径作为全髋关节置换前选择假体型号具有可行性。股骨颈内侧径测量法预测股骨假体型号的优秀率及优良率均高于模板测量法的优秀率及优良率（P〈0.01,P〈0.05）。当年龄〉45岁时,股骨颈内侧径测量法选择的假体型号优秀率可达66%,高于模板测量法的32%（P=0）。说明在全髋关节置换前计划时,采用股骨颈内侧径测量法预测股骨假体型号准确性高于模板法,并且股骨颈内侧径测量法更适用于中老年患者。
BACKGROUND：A good press-fit between the femoral component and the cross-section of medullary cavity of proximal femur is very important.The accuracy of preoperative templating of noncemented femoral prostheses is low.It is necessary to search a new method for preoperative prediction of total hip arthroplasty（THA）.OBJECTIVE：To analyze the application of preoperative medial-dimension measurement method of femoral neck to predict the size of suitable femoral prosthesis in THA.METHODS：Clinical data of 58 patients（65 hips） undergoing primary total hip arthroplasty were collected.Prediction to select femoral stem was based on the medial dimension of medullary cavity of femoral neck accurately measured from preoperative CT film.Conventional preoperative templating served as control.RESULTS AND CONCLUSION：The medial dimension of medullary cavity of femoral neck was correlated fairly well with sizes of the stems（r=0.84-0.85,P 0.05）,suggesting that the application of the medial dimension of medullary cavity of femoral neck was feasible for prediction of femoral component in THA.The excellent rate of predicted femoral stem and the excellent and good rate in the medial-dimension measurement method of femoral neck were greater than the preoperative templating（P 0.01,P 0.05）.Particularly,the excellent rate of medial-dimension measurement method of femoral neck was 66% in the group more than 45 years of age,greater than the preoperative templating method（32%,P=0）.As a measurement to predict the appropriate femoral implant in total hip arthroplasty,the medial-dimension measurement method of femoral neck has better accuracy than the conventional preoperative templating,particularly for the elderly.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第30期5535-5538,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
