Sun Guo-Yuan, Jiang Yan-Kun, Li Tong, Cong Xue-Feng, Huang Cheng, Ding Ran, Wang Wei-Guo, Zhang Qi-Dong
Graduate School of Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China.
Zhongguo Gu Shang. 2024 Sep 25;37(9):848-54. doi: 10.12200/j.issn.1003-0034.20240276.
To explore planning effect of AI-HIP assisted surgical planning system in primary unilateral total hip arthroplasty (THA) and its influence on clinical outcomes.
A retrospective analysis was conducted on clinical data of 36 patients who underwent their first unilateral THA from March 2022 to November 2022 and continuously used AI-HIP system (AI-HIP group), including 16 males and 20 females, aged from 43 to 81 years old with an average of (62.2±10.9) years old. According to the matching principle, 36 patients who were planned by the traditional template method at the same period were selected as the control group, including 16 males and 20 females, aged from 40 to 80 years old with an average of (60.9±12.1) years old. The accuracy between two groups of prostheses were compared, as well as the combined eccentricity difference between preoperative planning and postoperative practice, lower limb length difference, osteotomy height from the upper edge of the lesser trochanter and top shoulder distance to evaluate planning effect. Harris score and visual analogue scale (VAS) were used to evaluate clinical efficacy.
Both groups were followed up for 12 to 18 months with an average of (14.5±2.1) months. The complete accuracy and approximate accuracy of acetabular cup and femoral stalk prosthesis in AI-HIP group were 72.2%, 100%, 58.3%, 88.9%, respectively, which were better than 44.4%, 83.3%, 33.3%, 66.7% in control group (<0.05). There was no statistical significance in planning of femoral head prosthesis size (>0.05). The actual combined eccentricity difference and combined eccentricity difference (practical-planning) in AI-HIP group were 1.0(0.2, 2.4) mm and 1.1(-2.1, 3.2) mm, respectively;which were better than 3.0 (1.4, 4.9) mm and 3.5 (-1.6, 6.5) mm in control group (<0.05). There was no significant difference between two groups in actual osteotomy height of the upper margin of the lesser trochanter (>0.05). In AI-HIP group, the actual difference of lower extremity length after surgery, the difference of lower extremity length (practical-planning), osteotomy height from the upper margin of lesser trochanter (practical-planning), actual topshoulder distance after surgery, and topshoulder distance (practical-planning) were 1.5 (0.2, 2.8), 1.1 (-0.3, 2.2), 2.1(-2.3, 4.1), (15.3±4.1), 2.2(-4.8, 0.3) mm, respectively;which were better than control group of 2.6(1.3, 4.1), 2.5 (0.3, 3.8), 5.8(-2.4, 7.7), (13.0±4.3), -5.7(-9.4, -2.2) mm(<0.05). At final follow-up, there were no significant differences in Harris scores of pain, function, deformity, total scores and VAS between two groups (>0.05). The range of motion score was 4.8±0.6 in AI-HIP group, which was higher than that in control group (4.4±0.8)(<0.05).
Compared with traditional template planning, AI-HIP assisted surgical planning system has good accuracy in predicting the prosthetic size of the acetabular cup and femoral stalk, restoring joint eccentricity, planning lower limb length, osteotomy height and top shoulder distance on the first unilateral THA, and the clinical follow-up effect is satisfactory.
探讨AI-HIP辅助手术规划系统在初次单侧全髋关节置换术（THA）中的规划效果及其对临床疗效的影响。
回顾性分析2022年3月至2022年11月期间首次接受单侧THA并持续使用AI-HIP系统的36例患者的临床资料（AI-HIP组），其中男性16例，女性20例，年龄43至81岁，平均（62.2±10.9）岁。根据匹配原则，选取同期采用传统模板法规划的36例患者作为对照组，其中男性16例，女性20例，年龄40至80岁，平均（60.9±12.1）岁。比较两组假体的准确性，以及术前规划与术后实际情况之间的联合偏心距差异、下肢长度差异、小转子上缘截骨高度和顶肩距，以评估规划效果。采用Harris评分和视觉模拟量表（VAS）评估临床疗效。
两组均随访12至18个月，平均（14.5±2.1）个月。AI-HIP组髋臼杯和股骨干假体的完全准确性和近似准确性分别为72.2%、100%、58.3%、88.9%，均优于对照组的44.4%、83.3%、33.3%、66.7%（<0.05）。股骨头假体尺寸规划方面差异无统计学意义（>0.05）。AI-HIP组实际联合偏心距差异和联合偏心距差异（实际-规划）分别为1.0（0.2，2.4）mm和1.
