目的 探讨髋臼卵圆窝三维定位法辅助全髋关节置换术（total hip arthroplasty，THA）中髋臼假体定位的可行性和应用价值。 方法 将60例行初次THA的股骨颈骨折患者随机分为两组（各30例）。观察组应用髋臼卵圆窝三维定位法：术前基于CT数据测量髋臼角度、重建骨盆模型并规划，术中依据髋臼卵圆窝、横切迹、横韧带等解剖标志按规划置入假体。对照组采用传统徒手目测法。比较两组手术指标（时间、透视次数、出血量）、术后髋臼假体角度（外展角、前倾角）偏差、髋关节Harris评分（HHS）、疼痛视觉模拟评分（VAS）及脱位率。 结果 两组年龄、性别等基线资料可比。观察组出血量高于对照组（P < 0.001），手术时间、透视次数差异无统计学意义。术后影像学测量显示，观察组的髋臼假体外展角和前倾角偏差均显著小于对照组（P < 0.001）。术后1个月，观察组HHS评分明显更高、VAS评分明显更低（P < 0.05）；术后3、6个月两组功能与疼痛评分差异无统计学意义。观察组无脱位，对照组脱位1例。 结论 髋臼卵圆窝三维定位法结合解剖标志与个体化术前规划，能量化髋臼假体置入角度并显著提高髋臼假体置入的精准性，利于患者术后早期功能恢复，临床疗效满意，具有应用价值。

Objective To evaluate the feasibility and clinical significance of the three-dimensional acetabular oval fossa-guided positioning technique in acetabular prosthesis placement during total hip arthroplasty （THA）. Methods Sixty patients with femoral neck fractures who underwent primary THA were randomly divided into two groups （n = 30 per group）. The observation group received acetabular component placement guided by a three-dimensional positioning technique based on preoperative acetabular angle measurements and pelvic model reconstruction using CT data. During surgery， placement was performed according to the preoperative plan， using anatomical landmarks including the acetabular fossa， transverse acetabular incision， and transverse acetabular ligament. The control group underwent conventional freehand acetabular component placement. The two groups were compared in terms of surgical parameters （operation time， intraoperative fluoroscopy frequency， blood loss）， postoperative deviations in acetabular component angles （abduction and anteversion angles）， Harris hip score （HHS）， visual analog scale （VAS） for pain， and dislocation rate. Results Baseline characteristics were comparable between groups. The observation group exhibited a slightly longer operation time and significantly greater blood loss compared to the control group， with no significant difference in fluoroscopy frequency. Postoperative radiographic measurements showed that deviations in both the abduction and anteversion angles of the acetabular component were significantly smaller in the observation group than in the control group. At one month postoperatively， the HHS was significantly higher and the VAS score was significantly lower in the observation group. However， no significant differences in functional or pain scores were found between the two groups at three and six months postoperatively. No dislocations were observed in the observation group， whereas one dislocation occurred in the control group. Conclusions The three-dimensional acetabulum oval fossa-guided positioning technique， which integrates anatomical landmarks with individualized preoperative planning， enables precise quantitative measurement and significantly enhances the accuracy of acetabular component placement angles in THA. This improvement contributes to faster postoperative functional recovery and leads to favorable clinical outcomes， demonstrating strong practical application value.