CAJ | 학술논문

目的探讨应用髋臼中心定位器测量髋臼前后切迹连线中点至髋臼中心的方法,为人工全髋关节置换术中定位髋臼中心及安放髋臼假体提供解剖学依据.方法选取20具40侧正常成年人骨盆标本进行前瞻性研究,剥离骨盆软组织,显露出髋臼缘、髋臼前后切迹和Harris窝;通过髋臼的垂直径和水平径的交点确定髋臼的中心,并记录髋臼开口平面的垂直径和水平径数值,再利用髋臼中心定位器测量髋臼前后切迹连线中点至髋臼中心的距离(MAC).应用医学统计学软件对测得的实验数据进行分析,论证它们之间的相关性.结果髋臼开口平面的垂直径和水平径分别为45.50～ 55.60 mm、44.50～52.54 mm,使用髋臼中心定位器测得MAC为26.60～33.82 mm,平均为30.87mm,并观察到髋臼中心均在靠近卵圆窝内头侧接近月状关节软骨处.根据测量的MAC分别与髋臼开口平面的垂直径、水平径以及两者之和数据绘制散点图,提示MAC和髋臼开口平面水平径、垂直径、以及两者之和呈正性相关,Pearson系数r分别为0.89、0.81、0.91,从Pearson线性分析可知相比于MAC和垂直径或水平径,MAC和髋臼水平径与垂直径之和变量的相关系数更接近1,更具有明显的线性正性相关性.结论 MAC和髋臼水平径与垂直径之和呈线性正性相关性,提示可以通过测量髋臼水平径和垂直径的距离来得到MAC的值,从而可应用髋臼中心定位器在人工全髋关节置换术和翻修术中快速准确地确定髋臼中心,为正确安放髋臼假体,恢复髋关节解剖旋转中心提供一种新的方法.
목적 탐토응용관구중심정위기측량관구전후절적련선중점지관구중심적방법,위인공전관관절치환술중정위관구중심급안방관구가체제공해부학의거.방법 선취20구40측정상성년인골분표본진행전첨성연구,박리골분연조직,현로출관구연、관구전후절적화Harris와;통과관구적수직경화수평경적교점학정관구적중심,병기록관구개구평면적수직경화수평경수치,재이용관구중심정위기측량관구전후절적련선중점지관구중심적거리(MAC).응용의학통계학연건대측득적실험수거진행분석,론증타문지간적상관성.결과 관구개구평면적수직경화수평경분별위45.50～ 55.60 mm、44.50～52.54 mm,사용관구중심정위기측득MAC위26.60～33.82 mm,평균위30.87mm,병관찰도관구중심균재고근란원와내두측접근월상관절연골처.근거측량적MAC분별여관구개구평면적수직경、수평경이급량자지화수거회제산점도,제시MAC화관구개구평면수평경、수직경、이급량자지화정정성상관,Pearson계수r분별위0.89、0.81、0.91,종Pearson선성분석가지상비우MAC화수직경혹수평경,MAC화관구수평경여수직경지화변량적상관계수경접근1,경구유명현적선성정성상관성.결론 MAC화관구수평경여수직경지화정선성정성상관성,제시가이통과측량관구수평경화수직경적거리래득도MAC적치,종이가응용관구중심정위기재인공전관관절치환술화번수술중쾌속준학지학정관구중심,위정학안방관구가체,회복관관절해부선전중심제공일충신적방법.
Objective To discuss the measure of distance between the midpoint of acetabular notch line connecting and the centre point of acetabular by using acetabular center locator(ACL).To provide the anatomy basis for the man-made total hip replacement(THR) and to make sure the acetabular prosthesis is on the right place.Methods The specimens of pelvis (40 hips) from 20 normal adults were selected.The soft tissues of pelvis were peeled,and then get the labrum acetabulare,acetabular notch and Harris fossa.The center point of acetabulum was determined according to the intersection point of vertical diameter and horizontal diameter of acetabular bone.The distance between vertical diameter and horizontal diameter was recorded.The ACL was used to measure the distance between the midpoints of line connected with acetabular notches to the acetabular center (MAC).The data were analyzed by using statistic analysis software.Results The vertical line and horizontal line were 45.50-55.60 mm,44.50-52.54 mm.MAC was 26.60-33.82 mm,the average value of MAC was 30.87 mm.The acetabular center near the head round Harris fossa was closed to the acetabular articular surface.The scatter diagram was drawn according to the data of MAC with each of vertical line,horizontal line and the sum of vertical line and horizontal line.There was correlation between MAC and vertical diameter,horizontal diameter and the sum of vertical diameter and horizontal diameter.The Pearson coefficients (r) were 0.89,0.81 and 0.91,respectively.The variables coefficient between MAC and the sum of vertical diameter and horizontal diameter were more close to 1 according to the pearson linear analysis,compare with MAC and vertical diameter,MAC and horizontal diameter.There were more significant linear positive correlation between MAC and the sum of vertical diameter and horizontal diameter.Conclusions The Pearson linear analysis suggest an obvious linear positive correlation between MAC and the sum of acetabular horizontal line and the vertical line,which means the value of the MAC can be obtained by measuring the distance between acetabular horizontal diameter and vertical diameter.Thus the acetabular center locator can be used in THA and revision to get positioning center of acetabular rapidly and accurately.This is a practical method for acetabular component orientation.