全髋关节置换术后X线影像参数与髋关节功能改善程度的相关性研究-现代医学

全髋关节置换术后X线影像参数与髋关节功能改善程度的相关性研究

单位：东南大学医学院附属南京同仁医院骨科, 江苏南京 211102

分类号：R687.4

出版年·卷·期（页码）：2020·39·第八期（999-1005）

摘要：

目的：探讨全髋关节置换（THA）术后X线影像参数与关节功能改善程度的关系，以利于评估预后、指导并发症筛查及进行针对性的术后随访。方法：收集近3年于我院行单侧THA、规律随访时长达1年的患者共92例，根据末次随访时的Harris评分改善率将其分为显效组、有效组、改善组和无效组。在X线影像上测量每位患者术后1周和末次随访时的假体位置、角度、匹配度并评估稳定性、周围异位骨化等指标并比较四组结果的差异。结果：四组患者的髋臼假体水平距离、垂直距离和外展角的差异无统计学意义（P > 0.05），但髋臼假体外展角安全范围比例、股骨固定角度、匹配度、稳定性及异位骨化比例的差异具有统计学意义（P<0.05）。结论：X线影像参数是预示THA术后髋关节功能改善程度的重要指标，其中髋臼假体外展角安全范围比例、股骨固定角度、匹配度、稳定性及异位骨化比例最具相关性。

Objective: To investigate the relationship between X-ray imaging parameters and function improvement after THA for better prognosis evaluation, complications screening and targeted follow-up.Methods: A total of 92 patients who underwent unilateral THA in last 3 years and followed for 1 year were included. According to the Harris hip score at the last follow-up, patients were divided into excellent group, effective group, improved group and ineffective group. The prosthesis position, angle, matching degree, stability and heterotopic ossification on X-ray pictures were measured in the 1st week and at the last follow-up, the comparison between the four groups were conducted.Results: There was no significant difference in acetabular prosthesis horizontal distance, vertical distance and abduction angle between the four groups(P>0.05). The differences in the acetabular prosthesis abnormal abduction angle ratio, femoral fixation angle, prosthesis stability and heterotopic ossification among the four groups were statistically significant (P<0.05).Conclusion: X-ray imaging parameters are important indexes to predict the improvement of hip function after THA operation, among which the proportion of safe range of external angle of acetabular prosthesis, femoral fixation angle, matching degree, stability and ectopic ossification ratio are the most relevant.

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