WMG, University of Warwick, Coventry, CV4 7AL, UK.
Department of Orthopedic Surgery, Regensburg University, Medical Center, 93077, Bad Abbach, Germany.
Sci Rep. 2017 Aug 3;7(1):7238. doi: 10.1038/s41598-017-07644-4.
Impingement is a major source of dislocation and aseptic loosening in total hip arthroplasty (THA). We compared impingement free range of motion (ROM) using a novel computer navigated femur first approach to conventional THA. In addition, impingement between genders was also explored. In a retrospective analysis of 121 THA patients, subject-specific post-operative ROM was simulated using post-operative 3D-CT data, and compared with the benchmark ROM, essential for activities of daily living. Three parameters were defined to express both implant-to-implant (ITI) and bone-to-bone (BTB) impingement - coverage percentage, third angle, and impingement severity. Although coverage percentage was similar between the navigated and conventional group for both ITI (p = 0.69) and BTB (p = 0.82) impingement, third angle was significantly reduced in the navigation group for both ITI (p = 0.02) and BTB (p = 0.05) impingement. Impingement severity for both ITI (p = 0.01) and BTB (p = 0.05) was significantly decreased in the navigation group compared to the conventional. Impingement severity in men was considerably higher compared to women for both ITI (p = 0.002) and BTB (p = 0.02). Navigation guided femur first THA is able to improve alignment of ROM axis, and consequently, to reduce impingement in THA. Men seem to be more prone to impingement than women.
撞击是全髋关节置换术（THA）中脱位和无菌性松动的主要原因。我们比较了使用新型计算机导航股骨先入路与传统 THA 的无撞击活动范围（ROM）。此外，还探讨了性别间的撞击。在对 121 例 THA 患者的回顾性分析中，使用术后 3D-CT 数据模拟了特定于患者的术后 ROM，并与日常生活活动必需的基准 ROM 进行了比较。定义了三个参数来表示植入物间（ITI）和骨间（BTB）撞击-覆盖百分比、第三角度和撞击严重程度。尽管导航组和常规组的 ITI（p=0.69）和 BTB（p=0.82）撞击的覆盖百分比相似，但导航组的第三角度明显降低，ITI（p=0.02）和 BTB（p=0.05）撞击。与常规组相比，导航组的 ITI（p=0.01）和 BTB（p=0.05）撞击的严重程度显著降低。与女性相比，男性的 ITI（p=0.002）和 BTB（p=0.02）撞击的严重程度要高得多。与传统 THA 相比，导航引导股骨先入路 THA 能够改善 ROM 轴的对准，从而减少 THA 中的撞击。男性似乎比女性更容易发生撞击。
