假体方位角对全髋关节置换术后中远期疗效的影响-中医学专业论文.docxVIP

万方数据 万方数据 中文摘要 目的 研究全髋置换假体方位角与术后中远期疗效的关系，并为临床提供评 价标准。 方法 临床随访全髋置换术后患者 72 例，平均 6 年 5 个月，采用 Harris 评分法评估术后疗效，测量术后及近期 X 线片髋臼前倾角、外展角、股骨头旋转 中心位置及偏心距，并进行统计学分析。 结果 全髋置换术患者优良率为 93.0%（Harris 评分80 分）。72 例中脱位 2 例，有中度及以上疼痛者 3 例。优秀组（Harris 评分90 分）具有最为合适的 方位角。前倾角15°及外展角56°者脱位发生率显著增加。疼痛组股骨头旋转 中心的偏心距明显大于优良组。 结论 全髋置换术的疗效与髋臼前倾角、外展角、股骨头旋转中心及偏心距 密切相关，前倾角在 15°～25°、外展角 45°～56°及合适的股骨头旋转中心 位置和偏心距者术后中远期疗效满意。 主题词 全髋置换术;假体;方位角;疗效 ABSTRACT Effect of the prostheses position and orientation on total hip arthroplasty Objective A group of patients who had been applied total hip arthroplasty were followed up clinically and radiolocally to explore the effect of prostheses position and orientation on total hip arthroplasty about middium-and long- term results，by the measurement of the anteversion angle，the abduction angle，the position of the femoral head center and the femoral offset which could be used as a basis to evaluate clinical practice Methods A series of86hip joints（72pa-tients）were followed up.The average follow up period was77monthes.Harris evaluation systemwas used，and the anteversion angle，the abduction angle，the position of the femoral head center and the femoral offset were measured with AutoCAD2005.The results were statistically analyzed， with a Pvalue less than0.05indicating significant difference. Results 93.0%patients got the Harris score more than80.Two patients were found to have dislocation and three patients show moderate or severe painness. Patients who got the Harris score higher than90had the most ap-propriate position and orientation of the prostheses. The anteversion angle less than15°or the abduction angle more than56°was found to be associated with the greater risk of dislocation. The large femoral offset was associated with severe pain. Conclusion Based on the results of the study，the anteversion angle，the abduction angle，the position of the femoral head center and the femoral offset should be considered as the most important factors of the healing ef-fect after t