Bull Hosp Jt Dis (2013). 2021 Jun;79(2):78-83.
We investigated whether a novel, real-time fluoroscopybased navigation system optimized component positioning and leg length in fluoroscopically aided direct anterior approach total hip arthroplasty (DAA-THA). We retrospectively reviewed 75 fluoroscopically assisted DAA-THA performed by a single surgeon: 37 procedures used the software intraoperatively to overlay anteversion, inclination, and leg length information over the existing fluoroscopic radiograph with the aim of enhancing component positioning. The control group consisted of 38 procedures from the single surgeon's patient pool who had undergone non-navigated fluoroscopic assisted DAA-THA 1 month prior to the system's trial. Our results demonstrate that the navigation group measurements were significantly closer to the target numbers with less variation. The mean difference from target value were as follows: for anteversion (control: -4.68°, navigated: -01.0°), inclination (control: -1.87°, navigated: 0.8°), and leg length discrepancy (control: -2.59°, navigated: -0.98°). In addition, surgical time was shorter in the navigation group (75.7 vs. 74 minutes; p = 0.001). The real-time feedback and calculations provided by the navigation software provided a reproducible precision for component positioning and leg length measurement during DAA-THA.
我们研究了一种新的实时透视导航系统，该系统是否能优化全髋关节置换术中直接前入路（DAA-THA）的假体位置和下肢长度。我们回顾性分析了由同一位外科医生完成的 75 例透视辅助 DAA-THA：其中 37 例术中使用软件将前倾角、倾斜角和下肢长度信息叠加到现有的透视影像上，旨在增强假体位置。对照组由 38 例来自同一位外科医生患者池的患者组成，他们在该系统试用前 1 个月接受了非导航透视辅助 DAA-THA。我们的研究结果表明，导航组的测量值与目标值更接近，且变异更小。目标值的平均差值如下：前倾角（对照组：-4.68°，导航组：-01.0°）、倾斜角（对照组：-1.87°，导航组：0.8°）和下肢长度差异（对照组：-2.59°，导航组：-0.98°）。此外，导航组的手术时间更短（75.7 分钟 vs. 74 分钟；p=0.001）。导航软件提供的实时反馈和计算为 DAA-THA 中假体位置和下肢长度测量提供了可重复的精度。
