Takeda Yu, Fukunishi Shigeo, Nishio Shoji, Fujihara Yuki, Yoshiya Shinichi
Hyogo College of Medicine, Department of Orthopedic Surgery 1-1, Mukogawa-cho, Nishinomiya, Hyogo, Japan.
Open Orthop J. 2017 Dec 28;11:1432-1439. doi: 10.2174/1874325001711011432. eCollection 2017.
The purpose of this study was to examine the accuracy of implant orientation and leg length in total hip arthroplasty (THA) with an image-free navigation system based on a comparison of the intraoperative navigation and postoperative CT evaluations.
A consecutive series of 111 patients (118 hips) who underwent THA using the current version of the image-free navigation system constituted the basic study population. Subsequently, a total of 101 patients (108 hips) meeting the inclusion and exclusion criteria were selected as study subjects for the analysis. THA was performed using an image-free navigation system that was capable of adjusting both the prosthetic position and leg length. Postoperative CT examination was performed for all study subjects, and the prosthetic position and leg length were measured on CT images using the image analysis software. Subsequently, the intraoperative navigation results and the corresponding values obtained from the postoperative CT measurements were compared to test the accuracy of the navigation system.
The average discrepancies between the intra- and postoperative assessments were 6.8°, 3.7°, and 5.7° for cup anteversion, cup inclination, and stem anteversion, respectively. The corresponding value in leg length averaged 4.1 mm.
Average discrepancies between the intra- and postoperative measurements were less than 10° in all prosthetic alignment parameters and less than 5 mm in leg length. Intraoperative assessments with the use of the image-free navigation in THA could afford satisfactory result.
本研究的目的是通过比较术中导航和术后CT评估，检验基于无图像导航系统的全髋关节置换术（THA）中植入物方向和腿长的准确性。
连续111例患者（118髋）使用当前版本的无图像导航系统进行THA，构成基础研究人群。随后，共选择101例符合纳入和排除标准的患者（108髋）作为分析的研究对象。使用能够调整假体位置和腿长的无图像导航系统进行THA。对所有研究对象进行术后CT检查，并使用图像分析软件在CT图像上测量假体位置和腿长。随后，比较术中导航结果与术后CT测量获得的相应值，以测试导航系统的准确性。
髋臼前倾角、髋臼倾斜角和股骨柄前倾角的术中和术后评估平均差异分别为6.8°、3.7°和5.7°。腿长的相应平均值为4.1mm。
所有假体对线参数的术中和术后测量平均差异均小于10°，腿长差异小于5mm。在THA中使用无图像导航进行术中评估可获得满意结果。
