【摘要】 目的探讨三维CT重建技术在发育不良髋臼全髋人工关节置换术术前假体优选设计、髋臼重建、髋臼假体的正确放置及手术操作的指导作用。方法先天性髋臼发育不良继发骨性关节炎行全髋关节置换患者28例32髋,男6例6髋,女22例26髋;年龄21-63岁,平均年龄47.9岁。CrowⅠ型7例(9髋),CrowⅡ型9例(10髋),CrowⅢ型6例(7髋),CrowⅣ型4例(4髋)。全部病例进行髋臼及股骨中上段的三维CT扫描及重建,并选取同期PACS网络系统中CT扫描髋部结构完全正常数据作为对照研究。结果本组病例获得随访随访23例,随访时间8月-38月,平均随访19.6月。关节功能随访情况:本组病例术前平均Harris评分35.8分,术后3天平均Harris评分83.1分,术后15天出院时平均Harris评分91.2分,最终随访时间平均Harris评分87.6分。结论对于髋臼发育异常的髋关节疾病患者行全髋人工关节置换时,术前设计对于人工全髋关节的长期疗效至关重要。为更好了解髋臼发育不良程度需进行三维CT重建扫描,个体化设计假体,具有重要临床意义。更多还原

【Abstract】 Objective To investigate the role of three-dimensional CT reconstruction of acetabular dysplasia in the toatl hip arthroplasty prosthesis,including preferred design,acetabular reconstruction,putting the acetabular prosthesis in the right place and the guiding of operation.Methods 32 hips of 28 cases with congenital acetabular dysplasia secondary osteoarthritis have been performed with total hip arthroplasty.In this group,6 men with 6 hips,22 women with 26 hips;the average age was 47.9 years old(from21 to 63 years old).CrowⅠ-7 cases(9 hips),CrowⅡ-9 cases(10 total),CrowⅢ-6 cases(7 hips),CrowⅣ4-cases(4 hips).All cases of the acetabulum and the femur in the upper three-dimensional CT scan and reconstruction,and select the PACS network in the same period in hip structure of the CT scan data as a completely normal control study.Results In this group 23 cases were followed-up,with an average follow-up of 19.6 months(from8 months to 38 months).The preoperative Harris score was an average of 35.8 points.Harris score on 3 days after operation was an average of 83.1 points.Harris score on 15 days after operation was an average of 91.2 points,the final average Harris score of follow-up was 87.6 points.Conclusion For acetabular dysplasia patients with total hip arthroplasty,preoperative design is crucial to the long-term effect.To better understand the extent of acetabular dysplasia,three-dimensional reconstruction of CT scan and individual prosthesis design has important clinical significance.更多还原