计算机模拟全髋关节置换术后假体位置对关节稳定性的影响.DOC

计算机模拟全髋关节置换术后假体位置对关节活动的影响 斯海波，陈世荣，刘淼，庄万强 重庆医科大学，重庆 400016 【摘要】目的 通过计算机模拟全髋关节置换术，研究假体位置对关节活动度及稳定性的影响。 方法 以髋关节CT数据为基础，利用计算机三维重建及虚拟手术技术建立全髋关节置换术后三维模型，在不同假体位置对关节进行运动学分析，测量不同假体位置组合时关节发生撞击前的最大活动范围。 结果 (1)髋臼外展角增大可导致屈、伸、屈曲90°内旋活动范围增大，对外旋影响较小；髋臼及股骨前倾角增大均可导致屈及屈90°内旋活动范围增大，而伸及外旋均减小。(2) 为满足日常活动需要，当取较大髋臼外展角时，髋臼前倾角宜适当减小，而取较小髋臼前倾角时，股骨前倾角宜适当增大，反之亦然，而髋臼外展角与股骨前倾角的关系取决于髋臼前倾角。(3) 本结果可指导术后脱位患者日常活动范围及翻修术中假体安放。 结论 全髋关节置换术中把握好假体相对位置使关节前后方稳定性达到平衡至关重要。 【关键词】置换；髋；计算机辅助；假体植入；活动范围 【中图分类号】R687.4 【文献标识码】A Effect of the position of the components on hip motion in total hip replacement by computer model Si Haibo，Chen Shirong，Liu Miao，Zhuang Wanqiang Chongqing Medical University，Chongqing 400016，China 【Abstract】Objective To observe the effect of the position of the components on joint motion in total hip replacement. Methods A three-dimensional computer model of the hip after total hip replacement were created using digital CT images,and the model was designed to simulate joint motion and get maximum range of motion before impingement with different combinations of positioning of the components. Results （1）As the acetabular abduction increases,the amount of flexion,extension,internal rotation at 90°flexion before impingement increases,the acetabular abduction has little effect on external rotation;As the acetabular and femoral anteversion increases,the mount of flexion,internal rotation at 90°flexion increases,but extension,external rotation decreases.（2）To meet the needs of daily activities,when take a greater acetabular abduction,the acetabular anteversion should be appropriately reduced,and when take a smaller acetabular anteversion,the femoral anteversion should be appropriately increased,and vice versa,the relationship between acetabular abduction and femoral anteversion depends on the acetabular anteversion. Conclusion It’s essential to place the relative position of the components well and to achieve balance between anterior and posterior stability in total hip replacement.A