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在手术后前两年里,骨科植入物相对于骨组织的累积微动情况是可以测量的,测量结果可以预测植入物的机械松动。用于三维微动测量的最精确的X线成像方法是X线立体摄影测量分析法(RSA)。已证实的RSA方法的精确度为在移动方面是在0.05mm和0.5mm之间,在转动方面是在0.15度和1.15度之间。RSA方法用来研究植入方法的改变、覆盖物的增加或新型骨水泥等对假体稳固性的影响。RSA方法的优点是一般采用较少病人数量(25位病人)和较短时间的临床研究(2年)就足以预测很长时间内的植入物机械松动情况。这就促使RSA方法成为假体设计和开发研究中的重要检测工具,从而避免使大量病患处于新方法的潜在危险之中。在本文中,作者解释了RSA方法的基本原理,并列举了RSA的临床研究实例以阐释其临床应用。
In the first two years after surgery, the cumulative fretting of the orthopedic implant relative to the bone tissue is measurable, and the measurement can predict the mechanical loosening of the implant. The most accurate X-ray imaging method for three-dimensional fretting measurement is X-ray stereographic measurement analysis (RSA). The accuracy of the proven RSA method is between 0.05 mm and 0.5 mm for movement and between 0.15 and 1.15 degrees for rotation. The RSA method was used to study the effects of changes in implanting procedures, increased coverage, or new bone cement on the stability of the prosthesis. The advantage of the RSA method is that it is generally sufficient to predict the mechanical loosening of the implant over a long period of time with a relatively small number of patients (25 patients) and a short period of clinical study (2 years). This has prompted the RSA approach to become an important testing tool in the design and development of prosthetics to avoid putting a large number of patients at a potential risk of new approaches. In this article, the author explains the rationale for the RSA approach and cites examples of clinical research from RSA to illustrate its clinical utility.