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髋臼解剖结构在全髋关节置换方面的变异

Variations in acetabular anatomy with reference to total hip replacement.

作者信息

Murtha P E, Hafez M A, Jaramaz B, DiGioia A M

机构信息

Institute for Computer Assisted Orthopaedic Surgery, The Western Pennsylvania Hospital, Suite 242, Mellon Pavillion, 4815 Liberty Avenue, Pittsburgh, Pennsylvania 15224, USA.

出版信息

J Bone Joint Surg Br. 2008 Mar;90(3):308-13. doi: 10.1302/0301-620X.90B3.19548.

Abstract

Three-dimensional surface models of the normal hemipelvis derived from volumetric CT data on 42 patients were used to determine the radius, depth and orientation of the native acetabulum. A sphere fitted to the lunate surface and a plane matched to the acetabular rim were used to calculate the radius, depth and anatomical orientation of the acetabulum. For the 22 females the mean acetabular abduction, anteversion, radius and normalised depth were 57.1 degrees (50.7 degrees to 66.8 degrees ), 24.1 degrees (14.0 degrees to 33.3 degrees ), 25 mm (21.7 to 30.3) and 0.79 mm (0.56 to 1.04), respectively. The same parameters for the 20 males were 55.5 degrees (47.7 degrees to 65.9 degrees ), 19.3 degrees (8.5 degrees to 32.3 degrees ), 26.7 mm (24.5 to 28.7) and 0.85 mm (0.65 to 0.99), respectively. The orientation of the native acetabulum did not match the safe zone for acetabular component placement described by Lewinnek. During total hip replacement surgeons should be aware that the average abduction angle of the native acetabulum exceeds that of the safe zone angle. If the concept of the safe zone angle is followed, abduction of the acetabular component should be less than the abduction of the native acetabulum by approximately 10 degrees .

摘要

利用42例患者的容积CT数据得出的正常半骨盆三维表面模型,来确定天然髋臼的半径、深度和方向。用一个拟合于半月面的球体和一个匹配髋臼边缘的平面来计算髋臼的半径、深度和解剖学方向。对于22名女性,平均髋臼外展角、前倾角、半径和标准化深度分别为57.1度(50.7度至66.8度)、24.1度(14.0度至33.3度)、25毫米(21.7至30.3)和0.79毫米(0.56至1.04)。20名男性的相同参数分别为55.5度(47.7度至65.9度)、19.3度(8.5度至32.3度)、26.7毫米(24.5至28.7)和0.85毫米(0.65至0.99)。天然髋臼的方向与Lewinnek描述的髋臼组件放置安全区不匹配。在全髋关节置换术中,外科医生应意识到天然髋臼的平均外展角超过了安全区角度。如果遵循安全区角度的概念,髋臼组件的外展应比天然髋臼的外展小约10度。

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