Department of Orthopedics, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China.
Department of Quality Management and Evaluation, Orthopedic Hospital of Guangdong Province, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China.
J Orthop Surg Res. 2021 Feb 24;16(1):156. doi: 10.1186/s13018-021-02294-9.
Accurate preoperative planning is an important step for accurate reconstruction in total hip arthroplasty (THA). Presently, preoperative planning is completed using either a two-dimensional (2D) template or three-dimensional (3D) mimics software. With the development of artificial intelligence (AI) technology, AI HIP, a planning software based on AI technology, can quickly and automatically identify acetabular and femur morphology, and automatically match the optimal prosthesis size. However, the accuracy and feasibility of its clinical application still needs to be further verified. The purposes of this study were to investigate the accuracy and time efficiency of AI HIP in preoperative planning for primary THA, compared with 3D mimics software and 2D digital template, and further analyze the factors that influence the accuracy of AI HIP.
A prospective study was conducted on 53 consecutive patients (59 hips) undergoing primary THA with cementless prostheses in our department. All preoperative planning was completed using AI HIP as well as 3D mimics and 2D digital template. The predicted component size and the actual implantation results were compared to determine the accuracy. The templating time was compared to determine the efficiency. Furthermore, the potential factors influencing the accuracy of AI HIP were analyzed including sex, body mass index (BMI), and hip dysplasia.
The accuracy of predicting the size of acetabular cup and femoral stem was 74.58% and 71.19%, respectively, for AI HIP; 71.19% (P = 0.743) and 76.27% (P = 0.468), respectively, for 3D mimics; and 40.68% (P < 0.001) and 49.15% (P = 0.021), respectively, for 2D digital templating. The templating time using AI HIP was 3.91 ± 0.64 min, which was equivalent to 2D digital templates (2.96 ± 0.48 min, P < 0.001), but shorter than 3D mimics (32.07 ± 2.41 min, P < 0.001). Acetabular dysplasia (P = 0.021), rather than sex and BMI, was an influential factor in the accuracy of AI HIP templating. Compared to patients with developmental dysplasia of the hip (DDH), the accuracy of acetabular cup in the non-DDH group was better (P = 0.021), but the difference in the accuracy of the femoral stem between the two groups was statistically insignificant (P = 0.062).
AI HIP showed excellent reliability for component size in THA. Acetabular dysplasia may affect the accuracy of AI HIP templating.
准确的术前规划是全髋关节置换术（THA）中准确重建的重要步骤。目前，术前规划是使用二维（2D）模板或三维（3D）模拟软件来完成的。随着人工智能（AI）技术的发展，基于 AI 技术的 AI HIP 软件可以快速自动识别髋臼和股骨形态，并自动匹配最佳假体尺寸。然而，其临床应用的准确性和可行性仍需进一步验证。本研究旨在探讨 AI HIP 在初次 THA 术前规划中的准确性和时间效率，并与 3D 模拟软件和 2D 数字模板进行比较，进一步分析影响 AI HIP 准确性的因素。
前瞻性研究了我院 53 例（59 髋）接受非骨水泥假体初次 THA 的患者。所有术前规划均使用 AI HIP 以及 3D 模拟和 2D 数字模板完成。通过比较预测的组件尺寸和实际植入结果来确定准确性。比较模板时间以确定效率。此外，还分析了影响 AI HIP 准确性的潜在因素，包括性别、体重指数（BMI）和髋关节发育不良。
AI HIP 预测髋臼杯和股骨柄大小的准确性分别为 74.58%和 71.19%；3D 模拟分别为 71.19%（P=0.743）和 76.27%（P=0.468）；2D 数字模板分别为 40.68%（P<0.001）和 49.15%（P=0.021）。使用 AI HIP 的模板时间为 3.91±0.64 分钟，与 2D 数字模板相当（2.96±0.48 分钟，P<0.001），但短于 3D 模拟（32.07±2.41 分钟，P<0.001）。髋臼发育不良（P=0.021），而不是性别和 BMI，是影响 AI HIP 模板准确性的因素。与发育性髋关节发育不良（DDH）患者相比，非 DDH 组髋臼杯的准确性更好（P=0.021），但两组股骨柄的准确性差异无统计学意义（P=0.062）。
AI HIP 在 THA 中对组件尺寸具有出色的可靠性。髋臼发育不良可能会影响 AI HIP 模板的准确性。
