Qiu Yue, Xia Tianwei, Yuan Zhaofeng, Huan Dawei, Zhang Chao, Shen Jirong
Department of Traumatology & Orthopedics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210029, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Mar 15;37(3):284-289. doi: 10.7507/1002-1892.202211098.
To explore the feasibility of virtual reality (VR) technology combined with reduction plasty of the femoral head in the treatment of coxa plana and evaluate its effectiveness.
Three patients with coxa plana were selected as the research objects between October 2018 and October 2020, all of them were male, aged 15-24 years. Preoperative surgical planning was performed using VR technology; 256 rows of CT data of hip joint were imported into software to generate three-dimensional (3D) imaging, simulate the surgical process, and determine the matching relationship between the femoral head and acetabulum. According to the preoperative planning, reduction plasty of the femoral head under surgical dislocation, relative lengthening of the femoral neck, and periacetabular osteotomy were performed. The reduction of osteotomy size of femoral head and rotation angle of acetabulum were confirmed by C-arm fluoroscopy. The healing of the osteotomy were assessed by radiological examination after operation. The Harris score of hip function and visual analogue scale (VAS) score were recorded before and after operation. The femoral head roundness index, center-edge (CE) angle, and femoral head coverage were measured by X-ray films.
Three operations were completed successfully, and the operation time was 460, 450, and 435 minutes, and the intraoperative blood loss was 733, 716, and 829 mL, respectively. All patients were infused with 3 U suspension oligoleucocyte and 300 mL frozen virus inactivated plasma after operation. No postoperative complication occurred, such as infection and deep vein thrombosis. Three patients were followed up 25, 30, and 15 months, respectively. CT showed good healing of the osteotomy at 3 months after operation. The VAS score and Harris score at 12 months after operation and at last follow-up, as well as the femoral head rounding index, hip CE angle, and femoral head coverage at 12 months after operation significantly improved when compared with those before operation; the hip function was evaluated by the Harris score at 12 months after operation, and all three patients were good.
VR technology combined with reduction plasty of the femoral head can achieve satisfactory short-term effectiveness in the treatment of coxa plana.
探讨虚拟现实（VR）技术联合股骨头复位成形术治疗扁平髋的可行性并评估其疗效。
选取2018年10月至2020年10月间3例扁平髋患者作为研究对象，均为男性，年龄15 - 24岁。采用VR技术进行术前手术规划；将髋关节的256排CT数据导入软件生成三维（3D）影像，模拟手术过程，确定股骨头与髋臼的匹配关系。根据术前规划，在手术脱位状态下进行股骨头复位成形术、股骨颈相对延长术及髋臼周围截骨术。通过C形臂透视确认股骨头截骨大小的复位及髋臼的旋转角度。术后通过影像学检查评估截骨愈合情况。记录手术前后髋关节功能的Harris评分及视觉模拟量表（VAS）评分。通过X线片测量股骨头圆度指数、中心边缘（CE）角及股骨头覆盖率。
3例手术均成功完成，手术时间分别为460、450和435分钟，术中出血量分别为733、716和829毫升。术后所有患者均输注3单位悬浮少白细胞红细胞及300毫升病毒灭活冰冻血浆。未发生术后感染、深静脉血栓等并发症。3例患者分别随访25、30和15个月。术后3个月CT显示截骨愈合良好。与术前相比，术后12个月及末次随访时的VAS评分、Harris评分，以及术后12个月时的股骨头圆度指数、髋关节CE角和股骨头覆盖率均显著改善；术后12个月时采用Harris评分评估髋关节功能，3例患者均为优。
VR技术联合股骨头复位成形术治疗扁平髋可取得满意的短期疗效。
