骨盆旋转对全髋关节置换术中髋臼假体安放角度的影响

目的：研究骨盆沿人体三维方向旋转对全髋关节置换术中髋臼假体实际安放角度的影响规律。方法：采集正常成人的骨盆CT影像学资料，采用电脑软件三维重建骨盆髋臼并模拟骨盆分别围绕与人体矢状面、横断面和冠状面垂直的X轴、Y轴和Z轴旋转时，以标准角度植入髋臼假体时测量臼杯的放射外展角（radiographic inclination，RI）和放射前倾角（radiographic anteversion，RA）。采用相关性分析量化各个轴向旋转角度与髋臼实际角度的关系。结果：骨盆沿X轴及Y轴旋转时对髋臼的RA影响较小，但对RI影响较大并呈线性相关，回归方程分别为RA=0.682 4X+10.256（r²=0.308 4）和RA=-0.714 1Y+10.424（r²=0.999 8）；骨盆沿Z轴旋转时对RA几乎无影响，但与RI呈线性相关，回归方程为RI=1.0Z+46（r²=1.0）。结论：骨盆的前后旋转或沿躯体的纵轴旋转均明显影响髋臼的前倾角，但对外展角影响较小；相反，骨盆在冠状面上的左右歪斜可明显影响髋臼的外展角，但不影响其前倾角。

Effect of pelvic rotation on the placement angle of acetabular prosthesis in total hip arthroplasty

Objective:To study the effect of pelvic rotation in three-dimensional direction on the actual placement angle of acetabular prosthesis in total hip arthroplasty.Methods:Pelvic CT imaging data of normal adults were collected,and three-dimensional reconstruction of pelvic acetabulum was performed with computer software to simulate the rotation of the pelvis around X,Y and Z axes perpendicular to the sagittal,transverse and coronal planes of the human body. Radiographic inclination(RI) and radiographic anteversion (RA) of the acetabular cup were measured when the acetabular prosthesis was implanted at a standard angle. The correlation analysis was used to quantify the relationship between the rotation angle of each axis and the actual angle of acetabulum.Results:The pelvic rotation along the X-axis and Y-axis had little effect on the RA of the acetabulum,but had a great influence on the RI and showed a linear correlation. The regression equations were RA=0.682 4X+10.256(r²=0.308 4) and RA=-0.714 1Y+10.424(r²=0.999 8). The pelvic rotation along the Z-axis had little effect on the RA,but had a linear correlation with the RI,and the regression equation was RI=1.0Z+46(r²=1.0).Conclusion:The anteroposterior rotation of the pelvis or the longitudinal rotation along the body significantly affected the acetabular anteversion,but had little effect on the abduction angle. On the contrary,the left and right deviation of the pelvis on the coronal plane could significantly affect the acetabular anteversion angle,but did not affect its anteversion angle.