初次全髋关节置换术前胶片模板测量与评估

目的：通过胶片模板测量进行全髋关节置换术前计划、术后重复测量评估探讨胶片模板测量在全髋关节置换术前计划中的准确性和重要性。方法：2012年3月至2012年8月，收集我科同一位高年资医师行全髋关节置换病例72例（84髋）作研究对象。术前通过胶片模板测量，决定股骨颈截骨位置，计划髋臼、股骨柄、股骨头假体型号以及植入位置，调整双下肢长度；术后通过重复测量对术前计划进行评估和验证。结果：所有病例股骨颈截骨位置与术前计划相差均在5mm范围内，其中相差小于3mm者占84．5％。术前肢体平均短缩10mm（0～35mm），术后肢体平均短缩3mm（0-11mm），差异有统计学意义；术后双下肢长度相差在5mm以内者占90．5％。术前模板测量出的假体型号与实际应用的假体比较，髋臼假体完全符合率65．4％、相差1个型号以内的符合率为94．0％；股骨假体完全符合率为83．3％、相差1个型号以内的符合率为96．4％；股骨头假体完全符合率为63．1％、相差1个型号以内的符合率为98．8％。结论：全髋关节置换术前胶片模板测量对于术中假体型号选择具有较好的预测作用，对于假体位置安放以及双下肢长度调整均具有重要意义。

Accuracy of Preoperative Templating for Primary Total Hip Arthroplasty

Objective：To explore the accuracy and importance of preoperative templating in total hip arthroplasty through the preoperative template planning and postoperative repeated measurement. Methods：Da- ta of 72 patients （84 hips） undergoing total hip arthroplasty by the same senior surgeon were collected in our hospitals between March 2012 and August 2012. Preoperative templating measurement was conducted to deter- mine the femoral neck osteotomy, size of acetabulum implant, femoral stem, femoral head and length of lower extremities. Postoperative repeated measure was conducted to assess the accuracy of preoperative templating plan. Results：The difference of femoral neck osteotomy between preoperative planning and postoperative meas- urement were within 5 mm in all cases, with 84.5% within 3 ram. the average preoperative limb shortened 10 mm（ range 0 to 35 mm） , the average postoperative limb shortened 3 mm （range 0 to 11 mm） ,90.5% of pa- tients had limb length discrepancies controlled within 5 mm. Compared with the preoperative planned and actu- ally used components, completely coincidence rate was 65.4%, 83.3% and 63.1% in acetabular, femoral component and femoral head, respectively. The coincidence with one model of error was 94.0% , 96.4% and 98.8% in acetabular, femoral component and femoral head, respectively. Concluslons：The preoperative tem- plating plan can predict intraoperative selection of component accurately; it benefits prosthesis implantation and corrects leg length discrepancies.