影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (3): 448-452.DOI: 10.7517/issn.1674-0475.211203

• 综述与论文 • 上一篇    下一篇

THA术前CT三维重建对假体植入模拟的价值分析

张敬堂, 张斌斌, 李海亚   

  1. 皖南医学院附属太和医院骨科, 安徽 阜阳 236600
  • 收稿日期:2021-12-20 出版日期:2022-05-15 发布日期:2022-05-27

Value Analysis of CT Three-dimensional Reconstruction before THA for Prosthesis Implantation Simulation

ZHANG Jingtang, ZHANG Binbin, LI Haiya   

  1. Department of Orthopedics, The Taihe Hospital of Wannan Medical College, Fuyang 236600, Anhui, P. R. China
  • Received:2021-12-20 Online:2022-05-15 Published:2022-05-27

摘要: 本研究探讨全髋关节置换术(THA)术前采用CT三维重建实施假体植入模拟的临床应用价值。选择拟进行THA手术治疗的93例患者,采用随机数字表将其分为重建组(47例,术前采用CT三维重建模拟髋臼假体植入)和常规组(46例),两组均采用侧卧位直接前方入路全髋关节置换术。重建组术前CT三维重建模拟预测的臼杯外径、臼杯外展角、臼杯旋转中心水平距离和臼杯旋转中心垂直距离与手术中测量结果比较,差异均无统计学意义(P>0.05);术后1个月,重建组患者的SLS、跨步长度测定值均显著高于常规组,差异具有统计学意义(P<0.05);术后3个月,重建组患者的总体髋关节功能分布优于常规组患者,且差异具有统计学意义(P<0.05)。THA术前采用CT三维重建实施假体植入模拟能有效改善手术效果,提高假体植入准确性,对于改善患者的髋关节功能及术后步态功能具有更好的效果。

关键词: 全髋关节置换术, CT三维重建, 假体植入, 步态参数, 髋关节功能

Abstract: This study investigated the clinical application value of prosthesis implant simulation using CT three-dimensional reconstruction before total hip arthroplasty (THA). Selected 93 patients who were to undergo THA surgery and divided them into reconstruction group with 47 cases (preoperative CT three-dimensional reconstruction to simulate acetabular prosthesis implantation) and conventional group with 46 cases by random number table. Both groups underwent direct anterior approach total hip arthroplasty in the lateral decubitus position. There was no significant difference in the outer diameter of the cup, cup abduction angle, horizontal distance of the cup rotation center and vertical distance of the cup rotation center between predicted by the preoperative CT three-dimensional reconstruction simulation in the reconstruction group and the intraoperative measurement results (P>0.05). One month after operation, the measured values of SLS and stride length in the reconstruction group were significantly higher than those in the conventional group, and the difference was statistically significant (P<0.05). The distribution of joint function was better than that of the conventional group and the difference was statistically significant (P<0.05). Using CT 3D reconstruction to perform prosthesis implantation simulation before THA can effectively improve the surgical effect, improve the accuracy of prosthesis implantation, and has a better effect on improving the patient's hip joint function and postoperative gait function.

Key words: total hip replacement, CT three-dimensional reconstruction, prosthesis implantation, gait parameters, hip joint function