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全髋关节置换术数字模板:尺寸预测能力及观察者间差异

Total Hip Arthroplasty Digital Templating: Size Predicting Ability and Interobserver Variability.

作者信息

Montiel Veronica, Troncoso Santiago, Valentí-Azcárate Andrés, Valentí-Nin Juan Ramón, Lamo-Espinosa Jose María

机构信息

Department of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008 Pamplona, Navarra Spain.

出版信息

Indian J Orthop. 2020 Aug 3;54(6):840-847. doi: 10.1007/s43465-020-00217-0. eCollection 2020 Nov.

Abstract

BACKGROUND

During the last century, total hip arthroplasties have become more popular. They have had a huge impact on the quality of life, pain, range of motion, social interaction, and psychological well-being. A number of studies have emphasized the importance of using templates to choose the appropriate implant size when planning the surgery. Our aim is to use MediCad software to analyze the ability of the digital template system MediCad to predict the size of the implant needed in total hip arthroplasties.

MATERIALS AND METHODS

An arthroplasty preoperative plan was created according to the MediCad software guidelines, on anteroposterior hip X-ray by one junior resident, one senior resident, and three experienced hip surgeons.

RESULTS

The median size accuracy was 0.7 (range: 0.27-0.87) for the cup, 0.73 (range: 0.36-0.83) for the stem, and 0.28 (range: -0.14-0.69) for the neck. Interobserver reliability was good (kappa > 0.4) and stronger when measuring the stem than when doing so with the cup. Conclusion: Digital preoperative total hip arthroplasty planning is a good method for predicting component size, restoring hip anatomy (vertical offset and horizontal offset), with good interobserver reliability.

摘要

背景

在上个世纪,全髋关节置换术变得越来越普遍。它们对生活质量、疼痛、活动范围、社交互动和心理健康产生了巨大影响。许多研究强调了在手术规划时使用模板来选择合适植入物尺寸的重要性。我们的目的是使用MediCad软件来分析数字模板系统MediCad预测全髋关节置换术中所需植入物尺寸的能力。

材料与方法

由一名初级住院医师、一名高级住院医师和三名经验丰富的髋关节外科医生根据MediCad软件指南,在髋关节前后位X射线上创建关节置换术前计划。

结果

髋臼杯的中位尺寸准确性为0.7(范围:0.27 - 0.87),股骨柄为0.73(范围:0.36 - 0.83),股骨颈为0.28(范围:-0.14 - 0.69)。观察者间可靠性良好(kappa>0.4),测量股骨柄时的可靠性比测量髋臼杯时更强。结论:数字化全髋关节置换术前规划是预测假体尺寸、恢复髋关节解剖结构(垂直偏移和水平偏移)的良好方法,观察者间可靠性良好。

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