Jassim Shivan Sabah, Ingham Christopher, Keeling Matthew, Wimhurst James Anthony
Department of Trauma & Orthopaedics, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, Norfolk, UK.
Acta Orthop Belg. 2012 Jun;78(3):344-9.
Digital templating of pre-operative radiographs is increasingly utilised by surgeons before total hip arthroplasty (THA) as part of an adequate preoperative preparation to minimise complications. Templating can accurately predict the required implant sizes but its use in facilitating correction of leg length discrepancy (LLD) has been underreported in the literature. We performed a retrospective analysis of a cohort of consecutive patients undergoing primary THA. A comparison was made of the implant sizes templated with actual sizes used. In addition, pre-operative leg-length discrepancy (LLD) was noted and compared with intra-operative measurement of LLD correction and post-operative LLD correction seen on postoperative radiographs, as measured by two independent observers. Statistical analysis was performed to investigate the correlation between pre- and postoperative measurements. Fifty nine patients that had primary THA were investigated, 42 with hybrid replacements, 17 with cemented replacements. Spearman's-rho 2-tailed correlation between templated and implanted femoral offset, stem size and acetabular cup size was 0.850, 0.709 and 0.834 respectively (p < 0.01 for all). Correlation between the pre-operative templated LLD and the measured post-operative corrected LLD was 0.841 (p < 0.01). No difference existed between hybrid and cemented hips or the presence or absence of a contralateral hip replacement. In this study, templating for THA was significantly accurate in predicting the required femoral and acetabular implant sizes. In addition, the correction of pre-operative LLD was accurately performed, as evidenced by measurement on post-operative films. The results of this study support the pre-operative digital templating of radiographs in total hip arthroplasty.
在全髋关节置换术（THA）前，外科医生越来越多地使用术前X光片的数字模板，作为充分术前准备的一部分，以尽量减少并发症。模板可以准确预测所需的植入物尺寸，但在文献中其在促进腿长差异（LLD）矫正方面的应用报道较少。我们对一组连续接受初次THA的患者进行了回顾性分析。比较了模板化的植入物尺寸与实际使用的尺寸。此外，记录术前腿长差异（LLD），并与术中LLD矫正测量值以及术后X光片上两名独立观察者测量的术后LLD矫正值进行比较。进行统计分析以研究术前和术后测量值之间的相关性。对59例接受初次THA的患者进行了调查，其中42例采用混合置换，17例采用骨水泥固定置换。模板化与植入的股骨偏心距、柄尺寸和髋臼杯尺寸之间的Spearman秩相关系数分别为0.850、0.709和0.834（均p < 0.01）。术前模板化的LLD与测量的术后矫正LLD之间的相关性为0.841（p < 0.01）。混合髋和骨水泥固定髋之间或对侧髋关节置换与否之间不存在差异。在本研究中，THA模板在预测所需的股骨和髋臼植入物尺寸方面非常准确。此外，术前LLD的矫正准确完成，术后X光片测量结果证明了这一点。本研究结果支持全髋关节置换术中术前X光片的数字模板化。
