Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Orthopaedic Surgery, Kobe Kaisei Hospital, Kobe, Japan.
Sci Rep. 2021 Apr 7;11(1):7578. doi: 10.1038/s41598-021-86849-0.
This study aimed to investigate the accuracy of cup placement and determine the predictive risk factors for inaccurate cup positioning in robot-assisted total hip arthroplasty (THA). We retrospectively analyzed 115 patients who underwent robot-assisted THA between August 2018 and November 2019. Acetabular cup alignment and three-dimensional (3D) position were measured using pre- or postoperative computed tomography (CT) data. Absolute differences in cup inclination, anteversion, and 3D position were assessed, and their relation to preoperative factors was evaluated. The average measurement of the absolute differences was 1.8° ± 2.0° (inclination) and 1.9° ± 2.3° (anteversion). The average absolute difference in the 3D cup position was 1.1 ± 1.2 mm (coronal plane) and 0.9 ± 1.0 mm (axial plane). Multivariate analysis revealed that a posterior pelvic tilt [odds ratio (OR, 1.1; 95% confidence interval (CI), 1.00-1.23] and anterior surgical approach (OR, 5.1; 95% CI, 1.69-15.38) were predictive factors for inaccurate cup positioning with robot-assisted THA. This is the first study to demonstrate the predictive risk factors (posterior pelvic tilt and anterior surgical approach) for inaccurate cup position in robot-assisted THA.
本研究旨在探讨机器人辅助全髋关节置换术（THA）中髋臼杯放置的准确性，并确定髋臼杯定位不准确的预测风险因素。我们回顾性分析了 2018 年 8 月至 2019 年 11 月期间接受机器人辅助 THA 的 115 例患者。使用术前或术后计算机断层扫描（CT）数据测量髋臼杯的对齐和三维（3D）位置。评估髋臼杯倾斜度、前倾角和 3D 位置的绝对差异，并评估其与术前因素的关系。绝对差异的平均测量值为 1.8°±2.0°（倾斜度）和 1.9°±2.3°（前倾角）。3D 髋臼杯位置的平均绝对差异为 1.1±1.2mm（冠状面）和 0.9±1.0mm（矢状面）。多变量分析显示，骨盆后倾（比值比[OR]，1.1；95%置信区间[CI]，1.00-1.23）和前侧手术入路（OR，5.1；95%CI，1.69-15.38）是机器人辅助 THA 中髋臼杯定位不准确的预测因素。这是首次研究证明了机器人辅助 THA 中髋臼杯位置不准确的预测风险因素（骨盆后倾和前侧手术入路）。
