| 基于数字化分析全髋关节置换术后股骨偏心距及旋转中心与下肢不等长的相关性研究 |
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投稿时间：2023-08-15
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| 作者 | Author | 单位 | Address | E-Mail |
| 李茂勇 |
LI Mao-yong |
蚌埠医学院第一附属医院骨科组织移植 安徽省重点实验室 蚌埠医学院, 安徽 蚌埠 233004 |
Orthopaedic tissue Transplantation in the First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233004, Anhui, China |
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| 曹巍 |
CAO Wei |
蚌埠医学院第一附属医院骨科组织移植 安徽省重点实验室 蚌埠医学院, 安徽 蚌埠 233004 |
Orthopaedic tissue Transplantation in the First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233004, Anhui, China |
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| 沙培鑫 |
SHA Pei-xin |
蚌埠医学院第一附属医院骨科组织移植 安徽省重点实验室 蚌埠医学院, 安徽 蚌埠 233004 |
Orthopaedic tissue Transplantation in the First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233004, Anhui, China |
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| 孙旭东 |
SUN Xu-dong |
蚌埠医学院第一附属医院骨科组织移植 安徽省重点实验室 蚌埠医学院, 安徽 蚌埠 233004 |
Orthopaedic tissue Transplantation in the First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233004, Anhui, China |
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| 黄仕元 |
HUANG Shi-yuan |
蚌埠医学院第一附属医院骨科组织移植 安徽省重点实验室 蚌埠医学院, 安徽 蚌埠 233004 |
Orthopaedic tissue Transplantation in the First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233004, Anhui, China |
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| 李宽新 |
LI Kuan-xin |
蚌埠医学院第一附属医院骨科组织移植 安徽省重点实验室 蚌埠医学院, 安徽 蚌埠 233004 |
Orthopaedic tissue Transplantation in the First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233004, Anhui, China |
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| 张衡 |
ZHANG Heng |
蚌埠医学院第一附属医院骨科组织移植 安徽省重点实验室 蚌埠医学院, 安徽 蚌埠 233004
东部战区总医院骨科, 江苏 南京 210000 |
Orthopaedic tissue Transplantation in the First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233004, Anhui, China
Department of Orthopaedics, Eastern Theater General Hospital, Nanjing 210000, Jiangsu, China |
bygkzhangheng@163.com |
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| 期刊信息：《中国骨伤》2024年，第37卷，第4期，第381-386页 |
| DOI：10.12200/j.issn.1003-0034.20230313 |
| 基金项目: |
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中文摘要:
目的: 使用CT联合Mimics软件测量全髋关节置换术(total hip arthroplasty,THA)后股骨偏心距(femoral offset,FO)、旋转中心高度(rotation center height,RCH)与双下肢长度差(lower leg length discrepancy,LLD),并探讨THA后FO、RCH与LLD的关系。
方法: 回顾性分析2020年10月至2022年6月符合标准的40例行单侧THA的患者,其中男21例,女19例;年龄30~81(58.90±14.13)岁;身体质量指数(body mass index,BMI)为17.3~31.5(25.3±3.4) kg·m-2;左侧18例,右侧22例。诊断为股骨头坏死30例(Ficat Ⅳ期),髋关节骨性关节炎2例(Tönnis Ⅲ期),发育性髋关节脱位合并终末期骨关节炎2例(Crowe Ⅲ期),股骨颈骨折6例(Garden Ⅳ期)。术前、术后拍摄骨盆CT三维重建,经Mimics软件处理后建立三维重建模型,在模型上对FO、RCH、LLD进行测量。
结果: 术后双侧FO差值与LLD呈正相关性(r=0.744,P<0.001);将FO重建组与偏心距未重建组进行卡方检验得出:FO重建组下肢等长率高于FO未重建组(χ2=6.320,P=0.012)。术后双侧RCH差值与LLD呈负相关性(r=-0.877,P<0.001);双侧FO差值及双侧RCH差值与术后LLD之间存在线性关系,且满足线性回归方程:术后LLD=0.038x-0.099y+0.257(x为术后双侧FO差值;y为术后双侧RCH差值;单位为cm),F=077.993,R2=0.808,P=0.009。
结论: THA术后LLD随着FO的增大而增大,随着RCH增大而减小;重建FO更易获得下肢等长效果。THA术后双侧FO差值及双侧RCH差值与LLD之间存在线性关系,回归方程可为判断LLD提供一种理论参考。 |
| 【关键词】全髋关节置换术 股骨偏心距 旋转中心高度 下肢不等长 三维重建 |
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| Correlation between femoral offset,rotation center and leg length discrepancy after total hip arthroplasty based on digital analysis |
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ABSTRACT
Objective CT scans combined with Mimics software were used to measure femoral offset (FO),rotation center height (RCH) and lower leg length discrepancy (LLD) following total hip arthroplasty (THA),and the relationship between FO,RCH and LLD after THA is discussed.
Methods Retrospective analysis was performed on 40 patients with unilateral THA who met standard cases from October 2020 to June 2022. There were 21 males and 19 females,18 patients on the left side and 22 patients on the right side,aged range from 30 to 81 years old,with an average age of (58.90 ±14.13) years old,BMI ranged from 17.3 to 31.5 kg·m-2 with an average of (25.3±3.4) kg·m-2. There were 30 cases of femoral head necrosis (Ficat type Ⅳ),2 cases of hip osteoarthritis (Tönnis type Ⅲ),2 cases of developmental hip dislocation combined with end-stage osteoarthritis (Crowe type Ⅲ),and 6 cases of femoral neck fracture (Garden type Ⅳ). Three-dimensional CT reconstruction of pelvis was taken preoperative and postoperative,and three-dimensional reconstruction model was established after processing by Mimics software. FO,RCH and LLD were measured on the model. The criteria for FO reconstruction were as follows:postoperative bilateral FO difference less than 5 mm;the standard for equal length of both lower limbs was as follows:postoperative LLD difference less than 5 mm.
Results Bilateral FO difference was positively correlated with LLD (r=0.744,P<0.001). Chi-square test was performed between the FO reconstructed group and the non-reconstructed eccentricity group:The results showed that the isometric ratio of lower limbs in the FO reconstructed group was significantly higher than that in the FO reconstructed group (χ2=6.320,P=0.012). The bilateral RCH difference was significantly negatively correlated with LLD(r=-0.877,P<0.001). There is a linear relationship between bilateral FO difference and bilateral RCH difference and postoperative LLD,and the linear regression equation is satisfied:postoperative LLD=0.038x-0.099y+0.257(x:postoperative bilateral FO difference,y:postoperative bilateral RCH difference; Unit:cm),F=77.993,R2=0.808,P=0.009.
Conclusion After THA,LLD increased with the increase of FO and decreased with the increase of RCH. The effect of lower limb isometric length can be obtained more easily by reconstruction of FO. There is a linear relationship between the bilateral FO difference and the bilateral RCH difference after THA and LLD,and the regression equation can provide a theoretical reference for judging LLD. |
| KEY WORDS Total hip arthroplasty Femoral offset Rotation center height Leg length discrepancy 3D reconstruction |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李茂勇,曹巍,沙培鑫,孙旭东,黄仕元,李宽新,张衡.基于数字化分析全髋关节置换术后股骨偏心距及旋转中心与下肢不等长的相关性研究[J].中国骨伤,2024,37(4):381~386 |
| 英文格式: | LI Mao-yong,CAO Wei,SHA Pei-xin,SUN Xu-dong,HUANG Shi-yuan,LI Kuan-xin,ZHANG Heng.Correlation between femoral offset,rotation center and leg length discrepancy after total hip arthroplasty based on digital analysis[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(4):381~386 |
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