| Background:With the improvement of the level of science and technology,total hip arthroplasty(THA)has been widely recognized at home and abroad after extensive clinical trials and clinical application.Accurate assessment of the integrity and thickness of the acetabular wall is an important step in patients undergoing hip replacement.Preoperative placement of the prosthesis is of considerable importance.X-ray and CT are two essential imaging measures for assessing acetabular integrity and thickness before surgery.However,there is a significant difference in the accuracy of the evaluation.CT can accurately estimate the thickness of the inner wall of the real acetabulum,and the thickness measured by the X-ray has a large gap with the true thickness,and the thickness is greater than its true Thickness.Comparison of the advantages and disadvantages of CT and X-ray imaging.CT has the advantages of relatively high security,high density resolution,high ease of operation,fast speed,and clear display of the density and image difference of adjacent tissues in the pelvis.Of course,more important.It can accurately display the integrity and thickness of the inner wall of the acetabulum,which can improve the safety of the operation for THA.CT has the disadvantages of having a high inspection cost,having an appointment,a long inspection period,a long waiting time for inspection,and a large radiation.The X-ray has the following advantages: short appointment period,economical,convenient and simple,low emissivity.X-ray has the disadvantages: it can not accurately display the integrity and thickness of the inner wall of the acetabulum.This has the disadvantages of THA.The incidence of complications such as pelvic vascular and bladder destruction after surgery is higher than that of CT.Objective:To evaluate the agreement between pelvic X-ray film and pelvic CT measurement of the thickness of the acetabular inner wall.A retrospective analysis of 60 cases of THA in the orthopedic joint area of??our hospital from January to December 2018(experimental 50 cases,experiment2 10 cases),all patients(27 males,females)33 cases,mean age 61.38 years old(40years old to 88 years old).Experiment 1: 50 cases were diagnosed as femoral neck fractures(including left left case,right right 26 cases),pelvic X-ray and pelvis of patients with acetabulum using PACS system CT acetabular wall thickness(health /disease),acetabular up and down diameter,acetabular depth,abduction angle were measured,divided into X-ray measurement group and CT measurement group,the two groups of data can be compared and analyzed.The error range of the thickness of the inner wall of the acetabulum measured by the X-ray group and the thickness of the inner wall of the acetabulum measured by CT(ie,the difference between the inner wall of the acetabulum measured by X-ray and CT).Experiment 2: 10 cases were Patients diagnosed with femoral neck fractures(3 in the left,7 in the right),and patients with upcoming THA,using the PACS system on the acetabular acetabular wall thickness of the acetabular acetabulum(health/impair),acetabular diameter,The acetabular depth and abduction angle were measured,and the error range of experiment 1 was used to predict the true acetabular inner wall thickness.M,then all10 patients underwent pelvic CT examination,and the true acetabular wall value on CT was compared with the predicted acetabular wall value.Results:1.measurement of indicators.1)experiment 1: in the X-ray group,the thickness of the medial wall of the acetabulum was 6.78 ±1.85mm/6.87 ±1.70 mm,the diameter of the acetabulum was38.71 ±1.36 mm,the depth of the acetabulum was 17.61 ±2.20 mm,and the abduction angle was 43.53 ±1.76 °;In CT group,the thickness of medial acetabular wall(health/ disease)was 3.95 ±0.96mm/3.96 ±0.79 mm,the diameter of acetabulum was 37.55±1.33 mm,and the depth of acetabulum was 1.33 mm.It was 15.93 ±1.86 mm and the abduction angle was 41.80 ±1.87 °.The average "error range" between the value of acetabular internal wall measured by X-ray and the thickness of acetabular inner wall measured by CT(expressed by D),that is,D(health / disease)was 2.83mm(-Materials and methods:0.56mm~5.86mm)/ 2.91mm(-1.22mm~7.17mm).2)Experiment 2: in the X-ray group,the thickness of the medial wall of the acetabulum was 6.87 ±2.22mm/7.29 ±1.30 mm,the diameter of the acetabulum was38.29 ±1.80 mm,the depth of the acetabulum was 17.85 ±2.36 mm,and the abduction angle was 43.15 ±1.65 °;The thickness of medial acetabular wall(healthy / affected)was 4.74 ±1.07mm/ 4.63 ±0.75 mm in CT group.3)According to the results of experiment 1,the value M of medial acetabular wall was predicted to be 6.02 ±0.85mm/5.98 ±0.79 mm.2.Comparison of differences between the two groups.1)There were significant differences in acetabular medial wall,acetabular diameter,acetabular depth and abduction angle between X-ray group and CT group(P< 0.05).2)Experiment 2: the difference of medial acetabular wall(health / disease)between X-ray group and CT group was statistically significant(P < 0.05).3)There was also significant difference between the medial acetabular wall M predicted by experiment 1 and the medial acetabular wall value of CT group in experiment 2(P < 0.05).Conclusions:1.For hip arthroplasty,X-ray plain film and pelvic CT examination have a certain degree of agreement in measuring the thickness of the medial wall of acetabulum,that is,X-ray examination can also accurately evaluate the thickness of the medial wall of acetabulum.2.For hip arthroplasty,X-ray examination can not only reduce the risk of surgery,but also reduce the incidence of postoperative complications. |
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