Stigler Sophia K, Müller Franz J, Pfaud Sebastian, Zellner Michael, Füchtmeier Bernd
Sophia K Stigler, Franz J Müller, Sebastian Pfaud, Michael Zellner, Bernd Füchtmeier, Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, 93049 Regensburg, Germany.
World J Orthop. 2017 Jan 18;8(1):30-35. doi: 10.5312/wjo.v8.i1.30.
To analyze planning total hip arthroplasty (THA) with an additional anteroposterior hip view may increases the accuracy of preoperative planning in THA.
We conducted prospective digital planning in 100 consecutive patients: 50 of these procedures were planned using pelvic overview only (first group), and the other 50 procedures were planned using pelvic overview plus antero-posterior (a.p.) hip view (second group). The planning and the procedure of each patient were performed exclusively by the senior surgeon. Fifty procedures with retrospective analogues planning were used as the control group (group zero). After the procedure, the planning was compared with the eventually implanted components (cup and stem). For statistic analysis the χ test was used for nominal variables and the test was used for a comparison of continuous variables.
Preoperative planning with an additional a.p. hip view (second group) significantly increased the exact component correlation when compared to pelvic overview only (first group) for both the acetabular cup and the femoral stem (76% cup and 66% stem 54% cup and 32% stem). When considering planning ± 1 size, the accuracy in the second group was 96% (48 of 50 patients) for the cup and 94% for the stem (47 of 50 patients). In the analogue control group (group zero), an exact correlation was observed in only 1/3 of the cases.
Digital THA planning performed by the operating surgeon and based on additional a.p. hip view significantly increases the correlation between preoperative planning and eventual implant sizes.
分析在全髋关节置换术(THA)术前计划中增加前后位髋关节视图是否可提高术前计划的准确性。
我们对100例连续患者进行了前瞻性数字规划:其中50例手术仅使用骨盆整体视图进行规划(第一组),另外50例手术使用骨盆整体视图加前后位(a.p.)髋关节视图进行规划(第二组)。每位患者的规划和手术均由资深外科医生单独完成。将50例采用回顾性模拟规划的手术作为对照组(零组)。手术后,将规划与最终植入的部件(髋臼杯和股骨柄)进行比较。对于统计分析,χ检验用于名义变量,t检验用于连续变量的比较。
与仅使用骨盆整体视图(第一组)相比,术前增加前后位髋关节视图(第二组)进行规划时,髋臼杯和股骨柄的精确部件相关性均显著提高(髋臼杯:76%对54%,股骨柄:66%对32%)。当考虑规划尺寸±1时,第二组髋臼杯的准确率为96%(50例患者中的48例),股骨柄的准确率为94%(50例患者中的47例)。在模拟对照组(零组)中,仅1/3的病例观察到精确相关性。
由手术医生基于额外的前后位髋关节视图进行的数字THA规划显著提高了术前规划与最终植入尺寸之间的相关性。