Division of Orthopedic Surgery, St Michael's Hospital, Toronto, Ontario, Canada.
J Arthroplasty. 2010 Apr;25(3):445-9. doi: 10.1016/j.arth.2009.01.022. Epub 2009 Feb 28.
The current study investigated the accuracy and reliability of hip resurfacing component selection based on digital preoperative templating. Four surgeons made a template of preoperative radiographs on 2 occasions for acetabular and femoral components in 50 randomly selected hip resurfacing patients. Component selection reliability was variable among surgeons (kappa = 0.16-0.73) and fair between surgeons (kappa = 0.23-0.32). The average percentage of agreement for the acetabular component was 47% (range, 32%-64%) and for the femoral component was 54% (range, 38%-70%). Surgeons tended to underestimate implant size if the correct implant was not chosen (acetabular, 29%; femoral, 32%). Selection of an undersized femoral component may lead to femoral neck notching or varus implant alignment. This study emphasizes the need for intraoperative verification of preoperative templating results to ensure optimal implant selection in hip resurfacing.
本研究旨在探讨基于数字化术前模板的髋关节表面置换组件选择的准确性和可靠性。四位外科医生在两次分别对 50 例髋关节表面置换患者的髋臼和股骨组件进行术前 X 线片模板制作。外科医生之间的组件选择可靠性存在差异（kappa 值为 0.16-0.73），且介于中等水平（kappa 值为 0.23-0.32）。髋臼组件的平均一致性百分比为 47%（范围为 32%-64%），股骨组件的平均一致性百分比为 54%（范围为 38%-70%）。如果未选择正确的植入物，外科医生往往会低估植入物的尺寸（髋臼，29%；股骨，32%）。选择尺寸过小的股骨组件可能导致股骨颈开槽或植入物呈内翻对线。本研究强调了在髋关节表面置换中需要对术前模板结果进行术中验证，以确保最佳的植入物选择。
