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使用机械导航仪器改善杯位。

Improving cup positioning using a mechanical navigation instrument.

机构信息

Center for Computer Assisted and Reconstructive Surgery, New England Baptist Hospital, Tufts University School of Medicine, 125 Parker Hill Avenue, Suite 545, Boston, MA 02120, USA.

出版信息

Clin Orthop Relat Res. 2011 Feb;469(2):423-8. doi: 10.1007/s11999-010-1553-8.

Abstract

BACKGROUND

Although surgical navigation reduces the rate of malpositioned acetabular cups in total hip arthroplasty (THA), its use has not been widely adopted. As a result of our perceived need for simple and efficient methods of navigation, we developed a mechanical navigation device for acetabular cup orientation.

QUESTIONS/PURPOSES: We assessed accuracy of cup orientation (mean error of cup inclination and anteversion) of a novel mechanical navigation device, percentage of outliers, length of operation, and compared the results with a series of CT-based computer-assisted THAs.

METHODS

Cup orientation of 70 THAs performed using the mechanical navigation device was compared with a historical control group of 146 THAs performed using CT-based computer navigation. Postoperative cup orientation was measured using a validated two-dimensional/three-dimensional matching method. An outlier was defined outside a range of ± 10° from the planned inclination and/or anteversion.

RESULTS

Using the mechanical navigation device, we observed a decrease in the errors of inclination (1.3° ± 3.4° [range, -6.6° to 8.2°] versus 3.5° ± 4.2° [-12.7° to 6.9°]), errors of anteversion (1.0° ± 4.1° [-8.8° to 9.5°] versus 3.0° ± 5.8° [-11.8° to 19.6°]), percentages of outliers (0% versus 9.6%), and length of operation (112 ± 22 [78-184] minutes versus 132 ± 18 [90-197] minutes) compared with CT-based navigation.

CONCLUSIONS

Compared with CT-based surgical navigation, navigation of acetabular cup orientation using a mechanical device can be performed in less time, lower mean errors, and minimal equipment.

摘要

背景

尽管手术导航可降低全髋关节置换术(THA)中髋臼杯位置不当的发生率,但该技术并未得到广泛应用。由于我们认为需要一种简单有效的导航方法,因此我们开发了一种用于髋臼杯定向的机械导航装置。

问题/目的:我们评估了一种新型机械导航装置的髋臼杯定向准确性(髋臼杯倾斜和前倾角的平均误差)、离群值的百分比、手术时间,并将结果与一系列基于 CT 的计算机辅助 THA 进行了比较。

方法

将使用机械导航装置进行的 70 例 THA 的髋臼杯定向与使用基于 CT 的计算机导航进行的 146 例 THA 的历史对照进行比较。使用经过验证的二维/三维匹配方法测量术后髋臼杯定向。离群值定义为计划倾斜度和/或前倾角的 ± 10°范围之外。

结果

使用机械导航装置,我们观察到倾斜误差(1.3°±3.4°[范围,-6.6°至 8.2°])和前倾角误差(1.0°±4.1°[-8.8°至 9.5°])降低,离群值百分比(0%与 9.6%)和手术时间(112±22[78-184]分钟与 132±18[90-197]分钟)与基于 CT 的导航相比。

结论

与基于 CT 的手术导航相比,使用机械装置导航髋臼杯定向可以更快、更低的平均误差和最小的设备。

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