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—55.60mm、44.50—52.54mm,使用髋臼中心定位器测得MAC为26.60—33.82mm,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。
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 notehes 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 horizonta