Reynolds Adam, Doyle Ruben, Boughton Oliver, Cobb Justin, Muirhead-Allwood Sarah, Jeffers Jonathan
Biomechanical Engineering, Imperial College London, London, UK.
Surgery & Cancer, Imperial College London, London, UK.
Bone Joint Res. 2024 Apr 23;13(4):193-200. doi: 10.1302/2046-3758.134.BJR-2023-0224.R1.
Manual impaction, with a mallet and introducer, remains the standard method of installing cementless acetabular cups during total hip arthroplasty (THA). This study aims to quantify the accuracy and precision of manual impaction strikes during the seating of an acetabular component. This understanding aims to help improve impaction surgical techniques and inform the development of future technologies.
Posterior approach THAs were carried out on three cadavers by an expert orthopaedic surgeon. An instrumented mallet and introducer were used to insert cementless acetabular cups. The motion of the mallet, relative to the introducer, was analyzed for a total of 110 strikes split into low-, medium-, and high-effort strikes. Three parameters were extracted from these data: strike vector, strike offset, and mallet face alignment.
The force vector of the mallet strike, relative to the introducer axis, was misaligned by an average of 18.1°, resulting in an average wasted strike energy of 6.1%. Furthermore, the mean strike offset was 19.8 mm from the centre of the introducer axis and the mallet face, relative to the introducer strike face, was misaligned by a mean angle of 15.2° from the introducer strike face.
The direction of the impact vector in manual impaction lacks both accuracy and precision. There is an opportunity to improve this through more advanced impaction instruments or surgical training.
在全髋关节置换术（THA）期间，使用槌和导杆进行手动嵌压仍然是安装非骨水泥髋臼杯的标准方法。本研究旨在量化髋臼组件就位过程中手动嵌压敲击的准确性和精确性。这种认识旨在帮助改进嵌压手术技术，并为未来技术的发展提供信息。
一位骨科专家对三具尸体进行了后入路THA手术。使用仪器化的槌和导杆插入非骨水泥髋臼杯。分析了槌相对于导杆的运动，总共110次敲击分为低、中、高力度敲击。从这些数据中提取了三个参数：敲击向量、敲击偏移和槌面 alignment。
槌击的力向量相对于导杆轴线平均偏移18.1°，导致平均浪费敲击能量6.1%。此外，平均敲击偏移距导杆轴线中心19.8毫米，并且槌面相对于导杆敲击面平均偏移15.2°。
手动嵌压中冲击向量的方向缺乏准确性和精确性。有机会通过更先进的嵌压器械或手术培训来改善这一点。
