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髋关节置换术中的三维模板:模板导向器械的基础?

Three-dimensional templating in hip arthroplasty: the basis for template-directed instrumentation?

机构信息

Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hanover, Germany.

Institute for Forensic Medicine, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hanover, Germany.

出版信息

Arch Orthop Trauma Surg. 2020 Jun;140(6):827-833. doi: 10.1007/s00402-020-03394-7. Epub 2020 Mar 10.

Abstract

INTRODUCTION

Computed tomography-based three-dimensional models may allow the accurate determination of the center of rotation, lateral and anterior femoral offsets, and the required implant size in total hip arthroplasty. In this cadaver study, the accuracy of anatomical reconstruction was evaluated using a three-dimensional planning tool.

MATERIALS AND METHODS

A total of eight hip arthroplasties were performed on four bilateral specimens. Based on a computed tomography scan, the position and size of the prosthesis were templated with respect to the anatomical conditions.

RESULTS

On average, all parameters were reconstructed to an accuracy of 4.5 mm and lie within the limits recommended in the literature. All prostheses were implanted with the templated size.

CONCLUSIONS

The exact anatomy of the patient and the required size and position of the prosthesis were precisely analyzed using a templating software. Based on the present findings, the development of template-directed instrumentation is conceivable using this method. However, further technical features (e.g., navigation or robot-assisted surgery) are required for improved precision for implant positioning.

摘要

简介

基于计算机断层扫描的三维模型可用于准确确定全髋关节置换术中的旋转中心、股骨外侧和前侧偏移以及所需的植入物尺寸。在这项尸体研究中,使用三维规划工具评估了解剖重建的准确性。

材料与方法

在四个双侧标本上共进行了 8 例髋关节置换术。基于计算机断层扫描,根据解剖条件对假体的位置和大小进行模板化。

结果

平均而言,所有参数的重建精度均达到 4.5mm,并且在文献推荐的范围内。所有假体均按照模板尺寸植入。

结论

使用模板软件精确分析了患者的精确解剖结构以及所需假体的尺寸和位置。基于目前的研究结果,使用这种方法可以想象出基于模板的器械开发。然而,需要进一步的技术特征(例如导航或机器人辅助手术)来提高植入物定位的精度。

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