Lao Hong-Da, Liu Da, Cheng Bin, Liu Shu-Ling, Shuang Feng, Li Hao, Li Lei, Zhou Jiang-Jun
Department of Orthopedics, The 908th Hospital of The Joint Logistics Support Force (Great Wall Hospital Affiliated to Nanchang University), Nanchang, Jiangxi 335001, P.R. China.
Department of Orthopedics, General Hospital of Western Theater Command, Chengdu, Sichuan 610038, P.R. China.
Exp Ther Med. 2024 Mar 4;27(5):180. doi: 10.3892/etm.2024.12468. eCollection 2024 May.
The number of artificial total hip revision arthroplasties is increasing yearly in China, and >50% of these cases have acetabular defects. Accurately locating and quantifying the bone defect is one of the current challenges of this surgery. Thus, the objective of the present study was to simulate acetabular implantation with the aid of Mimics 17.0 software (Materialise NV) in patients with loosened acetabular prosthesis, to evaluate the 'ideal acetabular center' and the 'actual acetabular center' to guide the choice of prosthesis and surgical method. From January 2017 to June 2021, the present study included 10 hips from 10 patients [seven men (seven hips) and three women (three hips)]. In all patients, the Mimics software was applied to simulate the dislocation of the femoral prosthesis and acetabular prosthesis implantation before surgery; calculate the height difference between the 'ideal acetabular center' and the 'actual acetabular center' to assess the bone defect; confirm the size of the acetabular prosthesis, abduction angle, anteversion angle and bone coverage of the acetabular cup; and measure the intraoperative bleeding and postoperative follow-up Harris score of the hip joint. After statistical analysis, the present study revealed that digital simulation assistance could improve the accuracy of hip revision acetabular prosthesis implantation, reduce postoperative shortening of the affected limb, especially for surgeons with relatively little experience in hip revision surgery, and greatly reduce the occurrence of complications such as hip dislocation because of poor postoperative prosthesis position.
中国人工全髋关节翻修置换术的数量逐年增加,其中超过50%的病例存在髋臼缺损。准确确定骨缺损的位置并进行量化是该手术当前面临的挑战之一。因此,本研究的目的是借助Mimics 17.0软件(Materialise NV)对髋臼假体松动患者进行髋臼植入模拟,评估“理想髋臼中心”和“实际髋臼中心”,以指导假体选择和手术方法。2017年1月至2021年6月,本研究纳入了10例患者的10个髋关节[7例男性(7个髋关节)和3例女性(3个髋关节)]。所有患者在术前均应用Mimics软件模拟股骨假体脱位及髋臼假体植入;计算“理想髋臼中心”与“实际髋臼中心”的高度差以评估骨缺损;确定髋臼假体的尺寸、外展角、前倾角及髋臼杯的骨覆盖情况;并测量术中出血量及术后随访髋关节Harris评分。经统计分析,本研究表明数字模拟辅助可提高髋关节翻修髋臼假体植入的准确性,减少患肢术后缩短,尤其对于髋关节翻修手术经验相对较少的外科医生,还可大幅减少因术后假体位置不佳导致的髋关节脱位等并发症的发生。