Parvizi Javad, Benson Jessica R, Muir Jeffrey M
Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, College of Biomedical Science, Philadelphia, PA, USA.
Orthopaedics, Rothman Institute, Philadelphia, PA, USA.
Med Devices (Auckl). 2018 Mar 22;11:95-104. doi: 10.2147/MDER.S151835. eCollection 2018.
Computer-assisted navigation systems have been explored in total hip arthroplasty (THA) to improve component positioning. While these systems traditionally rely on anterior pelvic plane registration, variances in soft tissue thickness overlying anatomical landmarks can lead to registration error, and the supine coronal plane has instead been proposed. The purpose of this study was to evaluate the accuracy of a novel navigation tool, using registration of the anterior pelvic plane or supine coronal plane during simulated anterior THA.
Measurements regarding the acetabular component position, and changes in leg length and offset were recorded. Benchtop phantoms and target measurement values commonly seen in surgery were used for analysis. Measurements for anteversion and inclination, and changes in leg length and offset were recorded by the navigation tool and compared with the known target value of the simulation. Pearson's assessed the relationship between the measurements of the device and the known target values.
The device accurately measured cup position and leg length measurements to within 1° and 1 mm of the known target values, respectively. Across all simulations, there was a strong, positive relationship between values obtained by the device and the known target values (=0.99).
The preliminary findings of this study suggest that the novel navigation tool tested is a potentially viable tool to improve the accuracy of component placement during THA using the anterior approach.
在全髋关节置换术(THA)中已探索使用计算机辅助导航系统来改善假体组件的定位。虽然这些系统传统上依赖于骨盆前平面注册,但覆盖解剖标志的软组织厚度差异会导致注册误差,因此有人提出使用仰卧位冠状面。本研究的目的是评估一种新型导航工具的准确性,该工具在模拟前路THA过程中使用骨盆前平面或仰卧位冠状面注册。
记录有关髋臼组件位置以及腿长和偏移变化的测量值。使用手术中常见的台式模型和目标测量值进行分析。导航工具记录前倾角和倾斜度以及腿长和偏移的变化,并与模拟的已知目标值进行比较。皮尔逊相关性评估了设备测量值与已知目标值之间的关系。
该设备准确测量髋臼杯位置和腿长测量值,分别在已知目标值的1°和1毫米范围内。在所有模拟中,设备获得的值与已知目标值之间存在强正相关(=0.99)。
本研究的初步结果表明,所测试的新型导航工具是一种潜在可行的工具,可提高前路THA期间组件放置的准确性。