精确测量全髋关节置换术后髋臼假体前倾角的方法
A precise method for determining acetabular component anteversion after total hip arthroplasty
精确测量全髋关节置换术后髋臼假体前倾角的方法
译者：张峻
Aims: Several radiological methods of measuring anteversion of the acetabular component after total hip arthroplasty (THA) have been described. These are limited by low reproducibility, are less accurate than CT 3D reconstruction, and are cumbersome to use. These methods also partly rely on the identification of obscured radiological borders of the component. We propose two novel methods, the Area and Orthogonal methods, which have been designed to maximize use of readily identifiable points while maintaining the same trigonometric principles.
目的：文献报道了一些测量全髋关节置换术后（THA）髋臼假体前倾角的影像学方法。与CT三维重建相比，这些方法重复性较低，不够准确，应用起来较为复杂。这些测量方法一定程度上依赖于影像学片子上明显的假体边界。我们提出了两种新的方法，面积法和正交法，这两种方法的目的是在保持相同的三角原理的同时最大限度地利用容易识别的点。
Patients and methods: A retrospective study of plain radiographs was conducted on 160 hips of 141 patients who had undergone primary THA. We compared the reliability and accuracy of the Area and Orthogonal methods with two of the current leading methods: those of Widmer and Lewinnek, respectively.
病人和方法：回顾性研究141个病人160例行初次THAs的平片。我们比较了面积法和正交法与目前两种主要的方法：Widmer法和Lewinnek法的可靠性和准确性。
Results: The 160 anteroposterior pelvis films revealed that the proposed Area method was statistically different from those described by Widmer and Lewinnek (p < 0.001 and p = 0.004, respectively). They gave the highest inter- and intraobserver reliability (0.992 and 0.998, respectively), and took less time (27.50 seconds (sd 3.19); p < 0.001) to complete. In addition, 21 available CT 3D reconstructions revealed the Area method achieved the highest Pearson's correlation coefficient (r = 0.956; p < 0.001) and least statistical difference (p = 0.704) from CT with a mean within 1° of CT-3D reconstruction between ranges of 1° to 30° of measured radiological anteversion.
结果：160张骨盆正位片显示面积法与Widmer和Lewinnek的方法有统计学差异（p<0.001和p=0.004）。面积法具有最高的观察者间和观察者内信度（分别为0.992和0.998），完成的时间更短（27.50秒（标准差3.19）；p<0.001）。此外，21个可用的CT三维重建显示，面积法获得了最高的Pearson相关系数（r=0.956；p<0.001）和最小的统计差异（p=0.704），CT-3D重建的平均值在测量的放射学前倾角的1°到30°范围内。
Conclusion: Our results support the proposed Area method to be the most reliable, accurate, and speedy. They did not support any statistical superiority of the proposed Orthogonal method to that of the Widmer or Lewinnek method.
结论：面积法最可靠，准确，快速。结果不支持提出的正交方法比Widmer或Lewinnek方法有任何统计学上的优越性。
文献出处：Murphy MP, Killen CJ, Ralles SJ, Brown NM, Hopkinson WJ, Wu K. A precise method for determining acetabular component anteversion after total hip arthroplasty. Bone Joint J. 2019 Sep;101-B(9):1042-1049. doi: 10.1302/0301-620X.101B9.BJJ-2019-0085.R1. PMID: 31474147.