Orthopedic and Traumatology Surgery Department, Grenoble University Hospitals, Grenoble Alpes University, La Tronche, France; and.
TIMC-IMAG Lab, Univ. Grenoble Alpes, CNRS UMR 5525, La Tronche, France.
J Orthop Trauma. 2023 Nov 1;37(11S):S18-S22. doi: 10.1097/BOT.0000000000002689.
The objective of this study was to assess the impact of using simulation software for preoperative planning: a patient-specific biomechanical model (PSBM) in acetabular surgery. The secondary objectives were to assess operating time, intraoperative bleeding, and peroperative complications.
This is a prospective control study.
Level 1 trauma center.
PATIENTS/PARTICIPANTS: Between January 2019 and December 2022, patients with operative acetabular fracture treated by the first author were prospectively enrolled.
Patients were divided into 2 groups according to the use or not of PSBM for preoperative planning. When PSBM was used, data were extracted from the preoperative high-resolution computed tomography scans to build a biomechanical model implemented in a custom software [simulation (SIM group)]. When computed tomography scans were not performed in our hospital, PSBM was not feasible (non-SIM group).
Radiological results, surgery duration, blood loss, and peroperative complications were recorded.
Sixty-six patients were included; 26 in the PSBM group and 40 in the standard group. The 2 groups were comparable regarding fracture patterns and epidemiological data. After simulation, in the SIM group, a poor reduction (>3 mm) was found in 2 of 26 patients (7.7%) versus 11 of 40 patients (27.5%) in the non-SIM group, P = 0.048. The mean operative time was shorter after simulation (110 minutes vs. 155 minutes, P = 0.01), and the mean blood loss was reduced (420 vs. 670 mL, P = 0.01).
By reducing the peroperative trials for reduction, PSBM allows better reduction in a shorter operative time and with less blood loss.
Level II: prospective study.
本研究旨在评估术前规划中使用模拟软件（患者特定生物力学模型 [PSBM]）对髋臼手术的影响。次要目标是评估手术时间、术中出血和术中并发症。
这是一项前瞻性对照研究。
1 级创伤中心。
患者/参与者：2019 年 1 月至 2022 年 12 月期间，由第一作者治疗的手术髋臼骨折患者前瞻性入组。
根据术前规划是否使用 PSBM 将患者分为 2 组。当使用 PSBM 时，从术前高分辨率 CT 扫描中提取数据以构建在定制软件中实现的生物力学模型[模拟（SIM 组）]。当我们医院未进行 CT 扫描时，无法使用 PSBM（非 SIM 组）。
记录影像学结果、手术时间、失血量和术中并发症。
共纳入 66 例患者；26 例在 PSBM 组，40 例在标准组。2 组的骨折类型和流行病学数据具有可比性。模拟后，在 SIM 组中，26 例患者中有 2 例（7.7%）存在较差的复位（>3mm），而非 SIM 组中有 40 例患者中有 11 例（27.5%），P=0.048。模拟后手术时间更短（110 分钟 vs. 155 分钟，P=0.01），失血量减少（420 毫升 vs. 670 毫升，P=0.01）。
通过减少复位试验次数，PSBM 可在更短的手术时间内实现更好的复位，并减少出血量。
II 级：前瞻性研究。
