Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, Japan.
Orthopaedic Surgery, Kyowakai Hospital, Suita, Japan.
Bone Joint J. 2024 Mar 1;106-B(3 Supple A):104-109. doi: 10.1302/0301-620X.106B3.BJJ-2023-0840.R1.
Femoral component anteversion is an important factor in the success of total hip arthroplasty (THA). This retrospective study aimed to investigate the accuracy of femoral component anteversion with the Mako THA system and software using the Exeter cemented femoral component, compared to the Accolade II cementless femoral component.
We reviewed the data of 30 hips from 24 patients who underwent THA using the posterior approach with Exeter femoral components, and 30 hips from 24 patients with Accolade II components. Both groups did not differ significantly in age, sex, BMI, bone quality, or disease. Two weeks postoperatively, CT images were obtained to measure acetabular and femoral component anteversion.
The mean difference in femoral component anteversion between intraoperative and postoperative CT measurements (system accuracy of component anteversion) was 0.8° (SD 1.8°) in the Exeter group and 2.1° (SD 2.3°) in the Accolade II group, respectively (p = 0.020). The mean difference in anteversion between the plan and the postoperative CT measurements (clinical accuracy of femoral component anteversion) was 1.2° (SD 3.6°) in the Exeter group, and 4.2° (SD 3.9°) in the Accolade II group (p = 0.003). No significant differences were found in acetabular component inclination and anteversion; however, the clinical accuracy of combined anteversion was significantly better in the Exeter group (0.6° (SD 3.9°)) than the Accolade II group (3.6° (SD 4.1°)).
The Mako THA system and software helps surgeons control the femoral component anteversion to achieve the target angle of insertion. The Exeter femoral component, inserted using Mako THA system, showed greater precision for femoral component and combined component anteversion than the Accolade II component.
股骨部件前倾角是全髋关节置换术（THA）成功的重要因素。本回顾性研究旨在比较使用 Exeter 骨水泥股骨部件的 Mako THA 系统和软件与 Accolade II 非骨水泥股骨部件测量股骨部件前倾角的准确性。
我们回顾了 24 例患者的 30 髋（使用后外侧入路，使用 Exeter 股骨部件）和 24 例患者的 30 髋（使用 Accolade II 部件）接受 THA 的数据。两组在年龄、性别、BMI、骨质量或疾病方面无显著差异。术后 2 周，获取 CT 图像以测量髋臼和股骨部件前倾角。
Exeter 组术中与术后 CT 测量的股骨部件前倾角（部件前倾角的系统准确性）的平均差值为 0.8°（SD 1.8°），Accolade II 组为 2.1°（SD 2.3°）（p=0.020）。计划与术后 CT 测量的前倾角的平均差值（股骨部件前倾角的临床准确性）在 Exeter 组为 1.2°（SD 3.6°），在 Accolade II 组为 4.2°（SD 3.9°）（p=0.003）。髋臼部件倾斜度和前倾角无显著差异；然而，Exeter 组的组合前倾角的临床准确性（0.6°（SD 3.9°））明显优于 Accolade II 组（3.6°（SD 4.1°））。
Mako THA 系统和软件有助于外科医生控制股骨部件前倾角以实现目标插入角度。使用 Mako THA 系统插入的 Exeter 股骨部件在股骨部件和组合部件前倾角方面的精度优于 Accolade II 部件。
