髋关节旋转中心相关骨性参数的测量

目的 了解国人正常髋关节周围的骨性参数,探讨其对高位髋中心技术的影响. 方法 挑选CT表现完全正常且病例资料完整的男女各30例的影像资料,采用专用图像软件测量.测量参数:髋臼上方骨质的厚度、颈干角、偏心距、股骨头直径、骨盆高度及骨盆宽度.将年龄、体质量、性别和测量的各项参数值收集整理后进行统计分析. 结果 髋臼上方骨质形态在通过股骨头中心的冠状面上呈倒漏斗形,由远及近逐渐变薄,断面呈扇形,角度逐渐增大,半径逐渐变短.两性均在髋臼上方3 cm明显变薄,平均厚度男性为3.00 cm,女性为2.85 cm.男女两性之间的骨盆高度、骨盆宽度、颈干角、股骨头直径以及髋臼上方2 cm平面的骨质厚度等参数差异有统计学意义(P＜0.05),特别是颈干角,男性平均为121.42°,女性平均为135.42°,相差达14°,男女两性最小值与最大值相差达24.1°. 结论 髋臼上方骨质允许在全髋关节翻修术时垂直上方或上内方3 cm内放置高位髋中心.正常国人髋关节周围骨性参数男女差别较大,基于性别的差异,有必要在建立数据库时进行区别.

Measurement of osteo-parameters related to hip center

Objective To explore the effects of osteo-parameters of Chinese normal hips on the methods applied to the hish hip centre. Methods CT scans of 60(male 30,female 30)normal hips and pelves,taken from August 2004 to October 2005,were chosen from the database of the Roentgnographic Centre in the First Afiqliated Hospital of Sooehow University.The photographic analysis software of multispiral-CT produced by Marconi Inc.in the U.S was used.Three orthopedic graduate students measured the osteo-parameters of the bilateral hips respectively and worked out the mean values.The osteo-parameters included iliac Oflseous thickness of upper acetabulum,neck-shaft angle,offset,femoral head diameter,pelvic altitude and width.Age,bedy weight,gender,and osteo-parameters were statistically analyzed. Results The osseous COnfiguration of the upper acetabulum in the coronal section across the centre of femoral head is like an inverted funnel.In the cross-section.it is like a sector whose semidiameter changes gradually shorter with its gradually increased angle.The iliac osseous thickness of upper acetabulum averages 3.00 cm in male and 2.85 cm in female.There are significant differences between male and female in pelvic width and altitude.neck-shaft angle,femoral head diameter and the iliac osseous thickness at the 2 cm level of upper acetabulum.The mean neck.shaft angle is 121.42°fer male and 135.42°for female,with difference as great as 14°. Conclusions The upper acetabulum allows tlle hish hip centre to be lecated at the 3 cm vertically superior or superolateral level in total hip revision.Since there are significant differences between male and female in the osteo-parsmeters of Chinese normal hips,it is necessary to differentiate gender differences when establishing a database to guide the research and clinic practice.