目的探讨髋关节骨性强直行人工全髋关节置换术（total hip arthroplasty，THA）中髋臼假体定位方法及其准确性。 方法2009年1月－2013年3月采用THA治疗33例（49髋）髋关节骨性强直患者，其中男25例，女8例；年龄18～69岁，平均35.8岁。左髋10例，右髋7例，双髋16例。其中强直性脊柱炎18例，结核6例，创伤6例，骨性关节炎2例，化脓性感染1例。病程7～15年，平均10.8年。术中采用髋臼周围骨性标志（闭孔上缘、髋臼切迹等）及软组织标志（髋臼横韧带等）定位髋臼假体位置。术后摄髋关节或骨盆正位X线片，测量髋臼假体前倾角、外展角及上下、内外髋臼偏移度，并以前倾角15°、外展角45°、上下及内外髋臼偏移度为0作为参考值，评价髋关节骨性强直患者髋臼假体位置的准确性。 结果术中、术后均无血管神经损伤、骨折、脱位、感染等严重并发症发生。患者均获随访，随访时间13～63个月，平均30.3个月。末次随访时患者髋臼假体前倾角、外展角分别为（13.904±4.034）、（42.898±7.474）°，与参考值比较差异均无统计学意义（t=1.386，P=0.178；t=1.969，P=0.055）。内外及上下髋臼偏移度分别为（2.530±2.261）、（3.886±3.334）mm，与参考值比较差异均有统计学意义（t=7.830，P=0.000；t=8.159，P=0.000）；其中＜5 mm 29髋，5～10 mm 18髋，＞10 mm 2髋，贴合率达59.2%。 结论对于丧失正常解剖结构的骨性强直髋关节，THA术中充分利用残留及永久性解剖结构进行髋臼假体定位是比较准确的
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