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[髋关节置换术中不同髋臼杯类型的计算机辅助导航置入——一项随机对照试验]

[Computer-assisted navigated cup placement of different cup types in hip arthroplasty--a randomised controlled trial].

作者信息

Bernsmann K, Langlotz U, Ansari B, Wiese M

机构信息

Girardet Clinic Essen, Germany.

出版信息

Z Orthop Ihre Grenzgeb. 2001 Nov-Dec;139(6):512-7. doi: 10.1055/s-2001-19233.

Abstract

AIM

The position of the acetabular implant has a great influence on the outcome of total hip arthroplasty. The acetabular implants differ in their characteristics during insertion. In order to control the influence of the implant in different axes, 80 implantations of acetabular component were performed under computer-assisted control by a surogate navigation system.

METHOD

Within a prospective randomised study, 70 total hip replacements were performed by one surgeon using two different uncemented implants (PPF screw cup/Hedrocel pressfit cup). The position of the cup was measured at different times during surgery and was compared to 10 cemented PE cup placements.

RESULTS

During the milling procedure the anteversion of the two uncemented cups differed significantly (p = 0.026). The standard deviation of anteversion during implantation different significantly relating to the cup type: press-fit cup 3.86 degrees, screw cup 2.1 degrees and cemented PE cups 0,84 degrees. The inclination was less susceptible.

CONCLUSION

The cup design of uncemented acetabular implants influences the outcome of surgery. In our trial a spherical press-fit cup showed a greater variability than the screw-cup. The CAS system can be used as a tool to minimise these effects.

摘要

目的

髋臼假体的位置对全髋关节置换术的结果有很大影响。髋臼假体在植入过程中的特性各不相同。为了控制假体在不同轴向上的影响,在替代导航系统的计算机辅助控制下进行了80次髋臼部件植入。

方法

在一项前瞻性随机研究中,一名外科医生使用两种不同的非骨水泥型假体(PPF螺钉杯/ Hedrocel压配杯)进行了70例全髋关节置换术。在手术过程中的不同时间测量髋臼杯的位置,并与10例骨水泥型聚乙烯髋臼杯植入情况进行比较。

结果

在铣削过程中,两种非骨水泥型髋臼杯的前倾角差异显著(p = 0.026)。植入过程中前倾角的标准差因髋臼杯类型而异:压配杯为3.86度,螺钉杯为2.1度,骨水泥型聚乙烯髋臼杯为0.84度。倾斜度受影响较小。

结论

非骨水泥型髋臼假体的杯型设计会影响手术结果。在我们的试验中,球形压配杯的变异性比螺钉杯更大。计算机辅助手术系统可作为一种工具来尽量减少这些影响。

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