Spencer J M F, Day R E, Sloan K E, Beaver R J
Department of Medical Engineering and Physics, Royal Perth Hospital, 6 Selby Street, Shenton Park, Perth 6008, Western Australia.
J Bone Joint Surg Br. 2006 Jul;88(7):972-5. doi: 10.1302/0301-620X.88B7.17468.
Our aim was to assess the intra- and inter-observer reliability in the establishment of the anterior pelvic plane used in imageless computer-assisted navigation. From this we determined the subsequent effects on version and inclination of the acetabular component. A cadaver model was developed with a specifically-designed rod which held the component tracker at a fixed orientation to the pelvis, leaving the anterior pelvic plane as the only variable. Eight surgeons determined the anterior pelvic plane by palpating and registering the bony landmarks as reference points. The exact anterior pelvic plane was then established by using anatomically-placed bone screws as reference points. The difference between the surgeons was found to be highly significant (p < 0.001). The variation was significantly larger for anteversion (sd 9.6 degrees ) than for inclination (sd 6.3 degrees ). The present method for registering pelvic landmarks shows significant inaccuracy, which highlights the need for improved methods of registration before this technique is considered to be safe.
我们的目的是评估在无图像计算机辅助导航中用于确定骨盆前平面时观察者内和观察者间的可靠性。据此，我们确定了对髋臼组件旋转和倾斜的后续影响。我们开发了一种尸体模型，该模型带有一根专门设计的杆，该杆将组件跟踪器以固定方向固定在骨盆上，使骨盆前平面成为唯一变量。八位外科医生通过触诊并将骨性标志作为参考点进行记录来确定骨盆前平面。然后通过使用解剖位置的骨螺钉作为参考点来确定确切的骨盆前平面。发现外科医生之间的差异非常显著（p < 0.001）。前倾角的变异（标准差9.6度）明显大于倾斜角（标准差6.3度）。目前用于记录骨盆标志的方法显示出明显的不准确性，这突出表明在该技术被认为安全之前需要改进记录方法。
