摘要
目的:通过分析不同髋关节疾病的股骨头旋转中心变异情况为髋关节置换提供指导。方法:自2016年3月至2021年6月因各种原因拍射双髋关节正位等比例平片患者共5459例。测量股骨头旋转中心与大转子顶点的相对位置关系,高于大转子顶点2 mm以上为正变异,低于大转子顶点2 mm以上为负变异,共收集831例股骨头旋转中心变异的患者,按照不同疾病分为4组,其中正常组15例,10例为正变异,5例为负变异;股骨头缺血性坏死组145例,25例为正变异,120例为负变异;先天性髋关节发育不良组346例,正变异225例(其中CroweⅠ型25例,Ⅱ型70例,Ⅲ型115例,Ⅳ型15例),负变异121例(其中CroweⅠ型50例,Ⅱ型60例,Ⅲ型10例,Ⅳ型1例);髋关节骨性关节炎组325例,正变异45例,负变异280例。结果:各组患者组间比较,股骨头旋转中心变异情况差异有统计学意义(P<0.05),先天性髋关节发育不良组不同分型之间比较,股骨头旋转中心变异情况差异有统计学意义(P<0.05)。股骨头旋转中心不同变异情况在颈干角、偏心距的差异具有统计学意义(P<0.05)。结论:股骨头旋转中心变异与颈干角和偏心距有关。股骨头旋转中心变异是髋关节疾患的重要因素。股骨头旋转中心变异在不同髋关节疾病中变异情况不同,股骨头缺血性坏死及髋关节骨关节炎多为负变异。随着先天性髋关节发育不良程度的加重,股骨头旋转中心变异逐渐由负变异转为正变异。髋关节置换术前计划时要注意股骨头旋转中心的变异情况,对选择合适的假体和准确的安放假体有重要意义。
Objective To provide guidance for hip replacement by analyzing the variation of femoral head rotation center in different hip diseases.Methods A total of 5459 patients were collected from March 2016 to June 2021,who took positive and proportional plain films of both hips for various reasons.The relative position between the rotation center of the femoral head and the apex of the greater trochanter was measured.The positive variation is more than 2 mm above the top of the great trochanter,and the negative variation is more than 2 mm below the top of the great trochanter.A total of 831 patients with variation of femoral head rotation center were collected and were divided into 4 groups according to different diseases,and the variation was counted respectively.There were 15 cases in the normal group involving 10 cases of positive variation and 5 cases of negative variation.There were 145 cases of avascular necrosis of femoral head involving 25 cases of positive variation and 120 cases of negative variation.There were 346 cases of congenital hip dysplasia involving 225 cases of positive variation(including 25 cases of typeⅠ,70 cases of typeⅡ,115 cases of typeⅢand 15 cases of typeⅣ),and 121 cases of negative variation(including 50 cases of crowe typeⅠ,60 cases of typeⅡ,10 cases of typeⅢand 1 case of typeⅣ).There were 325 cases of hip osteoarthritis group involving 45 cases of positive variation and 280 cases of negative variation.Results There was significant difference in variation of femoral head rotation center among the four groups(P<0.05).There was significant difference in variation of femoral head rotation center among different types of congenital hip dysplasia(P<0.05).There were significant differences in cervical trunk angle and eccentricity among different variations of femoral head rotation center(P<0.05).Conclusion The variation of femoral head rotation center is related to cervical trunk angle and eccentricity.The variation of femoral head rotation center is an important factor in hip diseases.The variation of femoral head rotation center is different in different hip diseases.Avascular necrosis of the femoral head and osteoarthritis of the hip were mostly negative variations.With the aggravation of congenital hip dysplasia,the variation of femoral head rotation center gradually changed from negative variation to positive variation.The variation of femoral head rotation center should be paid attention to in the preoperative planning of hip arthroplasty.It is of great significance to select the appropriate prosthesis and place the prosthesis accurately.
作者
孙延山
王继成
吴长坤
郭永智
姜鑫
张阳阳
SUN Yan-shan;WANG Ji-cheng;WU Chang-kun;GAO Yong-zhi;XIN Jiang;ZHANG Yang-yang(The First Affiliated Hospital of Weifang Medical College,the First Department of Joint Surgery of Weifang People's Hospital,Weifang261000,Shandong,China)
出处
《中国骨伤》
CAS
CSCD
2023年第3期284-288,共5页
China Journal of Orthopaedics and Traumatology
基金
山东省医药卫生科技发展计划项目(编号:2016WS0660)。
关键词
关节成形术
置换
髋
股骨头旋转中心变异
股骨头坏死
髋脱位
先天性
Arthriplasty,replacement,hip
Variation of femoral head rotation center
Femoral head necrosis
Hip dislocation,congenital
