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数字模板在 Crowe Ⅱ型和Ⅲ型发育不良髋全髋关节置换术中的应用。

The utility of digital templating in Total Hip Arthroplasty with Crowe type II and III dysplastic hips.

机构信息

Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.

出版信息

Int Orthop. 2011 May;35(5):631-8. doi: 10.1007/s00264-010-0991-y. Epub 2010 Mar 14.

Abstract

With the superiority of digital imaging, conventional preoperative acetate templating is gradually being replaced by digital templating in total hip arthroplasty (THA). The purpose of this study was to assess the utility of digital templating for patients with Crowe type II and III dysplastic hips. In this study, 41 THA patients with Crowe type II or III dysplastic hips and 48 THA patients with other primary diseases were retrospectively reviewed. All patients were fitted with cementless prostheses in 2008. For the THA patients with dysplastic hips, we attempted to restore their hip centres to the position of the true acetabulum. Digital templating was the method chosen to achieve hip centre restoration. The prosthesis prediction accuracy (within ± one size using digital templating) was 20 (48.8%) for the cup size and 30 (73.2%) for the stem size. Meanwhile, for patients with other primary diseases, the accuracy for the cup size within ± one size was 34 (70.8%) and for the stem size accuracy was within ± one size in 38 (79.2%). Between the two patient groups, there was a significant difference in the predicted cup size. In patients with dysplastic hips, the low accuracy of the predicted cup size may have resulted from difficulty in predicting the vertical location of the hip centre. Despite this limitation, preoperative planning using digital templating is a convenient technique for THA patients with Crowe type II and III dysplastic hips.

摘要

数字化成像具有优势,传统的术前醋酸纤维模板技术在全髋关节置换术中(THA)逐渐被数字模板技术所取代。本研究旨在评估数字模板技术在 Crowe Ⅱ型和Ⅲ型髋关节发育不良患者中的应用价值。本研究回顾性分析了 2008 年接受非骨水泥假体治疗的 41 例 Crowe Ⅱ型和Ⅲ型髋关节发育不良患者和 48 例其他原发性疾病患者的 THA 病例。对于髋关节发育不良的 THA 患者,我们试图将其髋关节中心恢复到真髋臼的位置。选择数字模板技术来实现髋关节中心的重建。使用数字模板,假体预测的准确性(在±1 个尺码范围内)为杯的大小为 20 例(48.8%),柄的大小为 30 例(73.2%)。同时,对于其他原发性疾病患者,杯的大小在±1 个尺码范围内的准确性为 34 例(70.8%),柄的大小在±1 个尺码范围内的准确性为 38 例(79.2%)。两组患者之间,预测杯的大小存在显著差异。在髋关节发育不良的患者中,预测杯的大小准确性较低可能是由于难以预测髋关节中心的垂直位置所致。尽管存在这一限制,术前使用数字模板进行规划仍然是 Crowe Ⅱ型和Ⅲ型髋关节发育不良患者 THA 的一种方便技术。

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