Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Departments of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Int J Comput Assist Radiol Surg. 2017 Dec;12(12):2087-2096. doi: 10.1007/s11548-017-1577-6. Epub 2017 Apr 1.
The purpose of this preliminary study was to determine the error range compared with preoperative plans in proximal femoral osteotomy conducted using a computed tomography (CT)-based navigation system. METHODS : Four patients (four hips) underwent transtrochanteric rotational osteotomy (TRO), and three patients (four hips) underwent curved varus osteotomy (CVO) using CT-based navigation. Volume registration of pre- and postoperative CT was performed for error assessment. RESULTS : In TRO, the mean osteotomy angle error was [Formula: see text] (range [Formula: see text]) in the valgus direction and [Formula: see text] (range [Formula: see text]) in the retroversion direction. The mean osteotomy position error, with the femoral head side as positive, was -0.4 mm (range -1.4 to 0 mm). The bone fragment rotational movement error was [Formula: see text] (range [Formula: see text]). In CVO, the mean osteotomy position error, with the femoral head side as positive, was -0.2 mm (range -2.0 to 1.7 mm) at the level of the lesser trochanter and 0.8 mm (range 0-3.2 mm) at the level of the greater trochanter. Bone fragment varus accuracy was [Formula: see text] (range [Formula: see text]). CONCLUSIONS : In proximal femoral osteotomy using CT-based navigation, the angle error of osteotomy was within [Formula: see text] and the positional error was within 4 mm. The rotational movement error of the proximal fragment was within [Formula: see text]. These margins of error should be considered in preoperative planning. To improve surgical accuracy, it would be necessary to develop a computer-assisted device which can track the osteotomized fragment.
本初步研究旨在确定与术前计划相比，在基于计算机断层扫描（CT）的导航系统下进行股骨近端截骨术的误差范围。
4 名患者（4 髋）接受经转子间旋转截骨术（TRO），3 名患者（4 髋）接受基于 CT 的导航下的弧形内翻截骨术（CVO）。对术前和术后 CT 进行容积配准，以评估误差。
在 TRO 中，截骨角度的平均误差为[公式：见文本]（外翻方向，范围为[公式：见文本]）和[公式：见文本]（后倾方向，范围为[公式：见文本]）。股骨头侧为正的截骨位置误差平均值为-0.4 毫米（范围为-1.4 至 0 毫米）。骨块旋转运动误差为[公式：见文本]（范围为[公式：见文本]）。在 CVO 中，股骨头侧为正的截骨位置误差平均值为-0.2 毫米（范围为小转子水平-2.0 至 1.7 毫米）和 0.8 毫米（范围为大转子水平 0-3.2 毫米）。骨块内翻准确性为[公式：见文本]（范围为[公式：见文本]）。
在基于 CT 的导航下进行股骨近端截骨术，截骨角度的误差在[公式：见文本]内，位置误差在 4 毫米内。近端骨块的旋转运动误差在[公式：见文本]内。这些误差范围应在术前计划中考虑。为了提高手术准确性，有必要开发一种可以跟踪截骨骨块的计算机辅助设备。
