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改善全髋关节置换术中髋臼假体的位置:一项关于惯性导航工具和一种新型配准方法的尸体研究。

Improving Acetabular Component Positioning in Total Hip Arthroplasty: A Cadaveric Study of an Inertial Navigation Tool and a Novel Registration Method.

作者信息

Shatrov Jobe, Marsden-Jones Daniel, Lyons Matt, Walter William L

机构信息

Royal North Shore Hospital, St Leonards, NSW, Australia.

The University of Notre Dame Australia, Sydney, NSW, Australia.

出版信息

HSS J. 2022 Aug;18(3):358-367. doi: 10.1177/15563316211051727. Epub 2021 Nov 2.

Abstract

Incorrect acetabular component positioning in total hip arthroplasty (THA) has been associated with poor outcomes. Computer-assisted hip arthroplasty increases accuracy and consistency of cup positioning compared to conventional methods. Traditional navigation units have been associated with problems such as bulkiness of equipment and reproducibility of anatomical landmarks, particularly in obese patients or the lateral position. : We sought to evaluate the accuracy of a novel miniature inertial measurement system, the Navbit Sprint navigation device (Navbit, Sydney, Australia), to navigate acetabular component positioning in both the supine and lateral decubitus positions. We also aimed to validate a new method of patient registration that does not require acquisition of anatomical landmarks for navigation. : We performed THA in a cadaveric study in supine and lateral positions using Navbit navigation to record cup position and compared mean scores from 3 Navbit devices for each cup position on post-implantation CT scans. : A total of 11 cups (5 supine and 6 lateral) were available for comparison. A difference of 2.34° in the supine direct anterior approach when assessing acetabular version was deemed to be statistically but not clinically significant. There was no statistically significant difference between CT and navigation measurements of cup position in the lateral position. : This cadaveric study suggests that a novel inertial-based navigation tool is accurate for cup positioning in THA in the supine and lateral positions. Furthermore, it validates a novel registration method that does not require the identification of anatomical landmarks.

摘要

全髋关节置换术(THA)中髋臼假体组件定位不正确与预后不良相关。与传统方法相比,计算机辅助髋关节置换术提高了髋臼杯定位的准确性和一致性。传统导航设备存在诸如设备笨重以及解剖标志的可重复性问题,尤其是在肥胖患者或侧卧位时。我们旨在评估一种新型微型惯性测量系统——Navbit Sprint导航设备(Navbit,澳大利亚悉尼)在仰卧位和侧卧位引导髋臼假体组件定位的准确性。我们还旨在验证一种新的患者配准方法,该方法无需获取用于导航的解剖标志。我们在一项尸体研究中,使用Navbit导航在仰卧位和侧卧位进行THA,记录髋臼杯位置,并在植入后CT扫描上比较每个髋臼杯位置的3个Navbit设备的平均得分。共有11个髋臼杯(5个仰卧位和6个侧卧位)可供比较。在仰卧位直接前路评估髋臼前倾角时,2.34°的差异被认为具有统计学意义,但无临床意义。侧卧位时髋臼杯位置的CT测量值与导航测量值之间无统计学显著差异。这项尸体研究表明,一种新型的基于惯性的导航工具在仰卧位和侧卧位THA中对髋臼杯定位是准确的。此外,它验证了一种无需识别解剖标志的新型配准方法。

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