Schmid Jérôme, Chênes Christophe, Chagué Sylvain, Hoffmeyer Pierre, Christofilopoulos Panayiotis, Bernardoni Massimiliano, Charbonnier Caecilia
Geneva School of Health (HEdS), University of Applied Sciences of Western Switzerland (HES-SO), Av. de Champel 47, 1206, Geneva, Switzerland.
Medical Research Department, Artanim Foundation, Geneva, Switzerland.
Int J Comput Assist Radiol Surg. 2015 Oct;10(10):1547-56. doi: 10.1007/s11548-015-1177-2. Epub 2015 Apr 1.
Total hip arthroplasty (THA) aims to restore patient mobility by providing a pain-free and stable artificial joint. A successful THA depends on the planning and its execution during surgery. Both tasks rely on the experience of the surgeon to understand the complex biomechanical behavior of the hip. We investigate the hypothesis that a computer-assisted solution for THA effectively supports the preparation and execution of the planning.
We devised MyHip as a computer-assisted framework for THA. The framework provides pre-operative planning based on medical imaging and optical motion capture to optimally select and position the implant. The planning considers the morphology and range of motion of the patient's hip to reduce the risk of impingements and joint instability. The framework also provides intra-operative support based on patient-specific surgical guides. We performed a post-operative analysis on three patients who underwent THA. Based on post-operative radiological images, we reconstructed a patient-specific model of the prosthetic hip to compare planned and effective positioning of the implants.
When the guides were used, we measured non-significant variations of planned executions such as bone cutting. Moreover, patients' hip motions were acquired and used in a dynamic simulation of the prosthetic hip. Conflicts prone to implant failure, such as impingements or subluxations, were not detected.
The results show that MyHip provides a promising computer assistance for THA. The results of the dynamic simulation highlighted the quality of the surgery and especially of its planning. The planning was properly executed since non-significant variations were detected during the radiological analysis.
全髋关节置换术（THA）旨在通过提供无痛且稳定的人工关节来恢复患者的活动能力。成功的全髋关节置换术取决于手术规划及其执行情况。这两项任务都依赖外科医生的经验来理解髋关节复杂的生物力学行为。我们研究这样一个假设，即全髋关节置换术的计算机辅助解决方案能有效支持手术规划的准备和执行。
我们设计了MyHip作为全髋关节置换术的计算机辅助框架。该框架基于医学影像和光学运动捕捉提供术前规划，以优化植入物的选择和定位。规划考虑患者髋关节的形态和活动范围，以降低撞击和关节不稳定的风险。该框架还基于患者特定的手术导板提供术中支持。我们对三名接受全髋关节置换术的患者进行了术后分析。基于术后放射影像，我们重建了假体髋关节的患者特定模型，以比较植入物的计划定位和实际定位。
使用导板时，我们测量了诸如截骨等计划执行情况的无显著差异。此外，获取了患者的髋关节运动并将其用于假体髋关节的动态模拟。未检测到易导致植入物失败的冲突，如撞击或半脱位。
结果表明，MyHip为全髋关节置换术提供了有前景的计算机辅助。动态模拟的结果突出了手术尤其是其规划的质量。由于在放射学分析中检测到无显著差异，所以规划得到了正确执行。
