数字模型评估单次静脉注射唑来膦酸对髋关节置换术后假体早期移位影响.docVIP

数字模型评估单次静脉注射唑来膦酸对髋关节置换术后假体早期移位影响 　　[摘要] 目的 通过数字模型评估4 mg唑来膦酸单次静脉注射对股骨头坏死患者全髋关节术后早期假体移位的影响。 方法 将我院收治的30例股骨头坏死生物型全髋关节置换手术患者纳入研究队列，分为实验组及对照组。两组患者均给予全髋关节置换术，实验组术后第2～7天给予唑来膦酸静脉滴注，对照组予生理盐水。两组患者均定期通过薄层CT扫描（层厚0.3 mm）获取数据，利用Mimics 15.0软件的图像配准技术，将同一患者不同时期的数据融合为一个数据集，然后利用Segmentation功能分割图像获得不同时期骨骼及假体的3D模型，最后使用Measurements功能进行位移测量，对比假体移位率（术后7周、6个月、1年、2年），所有患者均完成2年随访。 结果 实验组和对照组在末次随访时假体（髋臼杯平均内移、上移）移位比较差异均有统计学意义（P0.05）。 结论 单次使用唑来膦酸在提高假体初始稳定性方面效果满意，因此可能有望提高股骨头坏死患者全髋关节置换术后的临床效果。 　　[关键词] 唑来膦酸；髋关节成形术；置换；数字模型；假体移位 　　[中图分类号] R687 [文献标识码] A [文章编号] 1673-9701（2017）33-0005-04 　　[Abstract] Objective To evaluate the effect of single intravenous injection of 4 mg zoledronic acid on the early postoperative prosthesis shift in patients with femoral head necrosis after total hip arthroplasty via the evaluation of digital model. Methods 30 patients with femoral head necrosis who were admitted to our hospital and received total hip replacement arthroplasty were included in the study， and were divided into experimental group and control group. Both groups were given total hip replacement arthroplasty. In the experimental group， intravenous drip of zoledronic acid was given on days 2-7 after surgery in the experimental group， and the control group was given normal saline. Data were collected via regular thin-layer CT scan（layer thickness of 0.3 mm） in both groups. Image registration technology in Mimics 15.0 software was used， and the data of the same patient at different times were merged into a data set， and then the Segmentation function was used to segment the image to obtain 3D models of bone and prosthesis at different times. Finally， Measurements function was used to perform shift measurement. The prosthesis shift rate was compared（7 weeks， 6 months， 1 year， 2 years after surgery）， All patients were followed up for 2 years. Results The differences of prosthesis shift rate（average internal shift and upper shift of acetabular cup） at the last follow-up visit in the experimental group and th