满足日常生活活动范围的髋臼假体角度安全范围及杯颈前倾角组合

目的：研究满足日常生活活动范围条件下，全髋关节置换术中髋臼杯角度安全范围及杯颈前倾角优化组合。方法：建立人工全髋关节三维可视化计算机模型，将髋关节屈曲≥110。、屈曲90。内旋≥30。、后伸≥30。、外旋≥40。定义为日常生活活动范围一般标准，而将屈曲≥120、屈曲90。内旋〉145。、后伸≥30。、外旋≥40。定义为严格标准，头颈直径比为2—2．92，假体颈前倾角为0一30，髋臼杯前倾角为0一70，外展角为10。～60。，颈干角设定为135。，计算满足上述两组活动范围，髋臼杯外展角每变化5。，相应的髋臼杯前倾角安装角度，在以臼杯外展角为横坐标，臼杯前倾角为纵坐标的坐标系上描点、连线画图进行描述，采用SAS6．12统计学软件对数据进行分析。结果：髋臼杯角度安全范围随着头颈直径比增大而增大，头颈比大于2．37时，臼杯角安全范围增大明显，严格标准活动度下的安全范围比一般标准条件下的小。颈干角135。，髋关节一般标准和严格标准活动度下，髋臼杯前倾角（y）与股骨假体前倾角（X）的关系分别为：Y1：一0．816X1＋39．76（R。=0．993），Y2=-0．873X2＋47．04（R^2=0．999）。结论：头颈直径比较大的假体髋臼杯角安全范围明显增大，建议选择头颈比直径大于2．37的假体。髋关节活动范围要求越高，髋臼杯角度安全范围就越小，但可以通过选择较大头颈直径比的假体来纠正。杯颈前倾角呈负相关。

The cup safe-zone and optimum combination of the acetabular and femoral anteversions that fulfills the desired range of motion of the hip

To investigate safe range of acetabular prosthesis angle and the optimum combination of cup and neck in the range of activities of daily living （ADL）. Methods：A three-dimensional generic parametric and kinematic simula- tion module of THA was developed. Range of motion （ROM） of flexion/〉 110, internal-rotation t〉 30 at 90 flexion, extension /〉30 and external rotation I〉40 were defined as the normal criteria for desired ROM for activities of daily living（ADL） ,and ROM of flexion /〉 120, internal-rotation t〉 45 at 90 flexion, extension 1〉 30and external rotation I〉 40as the severe crite- ria. The range of the changes in the general head-neck ratios （GR）,the femoral neck anteversion （FA）, the operative antever- sion （OA） and operative inclination （OI） of the cup component were 2-2.92,00-30 ,0-70, 10-60~respectively. For the collodiaphyseal angle （CCD） of 135,the corresponding OA related to the Ol which every 5~ was calculated, and described us- ing dots and lines in a coordinate system in which OI of acetabular cup was the horizontal ordinate and OA of acetabular cup was the vertical ordinate. All data was analyzed by sAs 6.12 software. Results：Large GR greatly increased the size of safe range and it was recommended that GR be more than 2.37 when the CCD-angle was 135 as it further increases the size of safe- zone. The size of cup safety range of the severe criteria was smaller than normal criteria. When the CCD-angle was 135~ ,the optimum relationship between OA of acetabular and FA of the normal criteria and the severe criteria can be estimated by the formula：Yl=-0.816Xl＋39.76 （R2--0.993）,Yz=-0.873X2＋47.04 （R：--0.999） respectively. Conclusion：Large GR greatly in- creases the size of safe-zone and it is recommended that GR be more than 2.37, so it extends the acceptable range of error that clinicians cannot avoid it completely. The larger range of the hip motion, the smaller size of the cup safe-zone, but can retrieve by increase the GR. The OA is negative with FA.