Yu Zhong, Wang Liming, Gui Jianchao
Department of Orthopedics, Nanjing First Hospital Affiliated to Nanjing Medical Universty, Nanjing Jiangsu 210006, PR. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2007 Oct;21(10):1057-61.
To improve the accuracy of the acetabular component placement using the non-image based surgical navigation system.
Twenty-three patients (14 males, 9 females; age, 28-55 years; 26 hips) with hip disease underwent the total hip arthroplasty (THA) using the non-image based surgical navigation system from February 2004 to April 2006. Rheumatoid arthritis was found in 3 patients (3 hips), necrosis of the femoral head in 6 patients (6 hips), and osteoarthritis in 14 patients (16 hips). All the patients were randomly divided into the following 2 groups: the navigated group (11 patients, 13 hips), treated by THA using the non-image based surgical navigation system; and the control group (12 patients, 13 hips), treated by the traditional THA. According to the design of the study, the acetabular component was placed in the best inclination angle (45 degrees) and the anteversion angle (15 degrees). The postoperative component position was examined.
No fracture, dislocation, infection or injury to the sciatic nerve was found. In the navigated group, the inclination and the anteversion reached 15.4 +/- 1.4 degrees and 45.5 +/- 1.3 degrees, respectively. In the control group, the inclination and the anteversion were 13.9 +/- 7.6 degrees and 43.7 +/- 6.4 degrees, respectively. The inclination difference was considered statistically significant (P < 0.01). All the patients were followed up for 10-40 months,averaged 26 months. In the navigated group, the postoperative average Harris hip score was 95 (range, 85-110), with an excellent result in 11 hips and a good result in 2 hips. In the control group, the postoperative average Harris hip score was 92 (range, 75-110), with an excellent result in 9 hips, a good result in 3 hips, and a fair result in 1 hip. The Harris hip score difference was considered statistically significant (P < 0.05). There was a significantly better result obtained in the navigated group than in the control group.
The acetabular component can be implanted accurately by the non-image based surgical navigation system, which can reduce the incidence of the loosening of the prostheses and has an important value in clinical practice.
使用非影像引导手术导航系统提高髋臼假体置入的准确性。
2004年2月至2006年4月，23例髋部疾病患者（男14例，女9例；年龄28 - 55岁；26髋）接受了使用非影像引导手术导航系统的全髋关节置换术（THA）。其中类风湿关节炎患者3例（3髋），股骨头坏死患者6例（6髋），骨关节炎患者14例（16髋）。所有患者随机分为以下两组：导航组（11例患者，13髋），采用非影像引导手术导航系统行THA治疗；对照组（12例患者，13髋），采用传统THA治疗。根据研究设计，髋臼假体以最佳倾斜角（45度）和前倾角（15度）置入。术后检查假体位置。
未发现骨折、脱位、感染或坐骨神经损伤。导航组中，倾斜角和前倾角分别达到15.4±1.4度和45.5±1.3度。对照组中，倾斜角和前倾角分别为13.9±7.6度和43.7±6.4度。倾斜角差异具有统计学意义（P < 0.01）。所有患者随访10 - 40个月，平均26个月。导航组术后Harris髋关节评分平均为95分（范围85 - 110分），其中优11髋，良2髋。对照组术后Harris髋关节评分平均为92分（范围75 - 110分），其中优9髋，良3髋，可1髋。Harris髋关节评分差异具有统计学意义（P < 0.05）。导航组的结果明显优于对照组。
非影像引导手术导航系统可准确植入髋臼假体，能降低假体松动发生率，在临床实践中具有重要价值。
