Zhu Haotian, Wu Jiayi, Cheng Kai, Yan Han, Liang Junjun, Long Yunjin, Fan Shaoxing, Zhang Yadi, Ding Huanwen
South China University of Technology School of Medicine, Guangzhou, Guangdong, China.
Guangdong Pharmaceutical University, Guangzhou, Guangdong, China.
Orthop Surg. 2025 Mar;17(3):831-840. doi: 10.1111/os.14335. Epub 2024 Dec 26.
Although total hip arthroplasty (THA) effectively alleviates pain and restores joint function in the end-stage hip disease, challenges remain in achieving precise osteotomy and minimizing subjective dependency on prosthesis positioning. This study aims to evaluate the efficacy and safety of preoperative virtual planning and navigation templates compared to conventional techniques, providing new methods to enhance the precision and personalization of THA.
During the period from 2022 to 2023, we conducted a retrospective case-control study on 74 patients who underwent THA surgery at our hospital, based on the inclusion and exclusion criteria. The study included 42 patients in the traditional method group, who underwent preoperative planning and surgical procedures according to traditional methods; and 32 patients in the digital assistance group, who used computer-assisted virtual preoperative planning and three-dimensional printed personalized navigation templates to assist in the surgery. The main parameters of the two groups were compared, including surgical time, blood loss, postoperative femoral anteversion, neck-shaft angle, anatomical-mechanical femoral axis angle (aMFA), leg length discrepancy (LLD), and the angle of hip prosthesis placement. The Harris hip score was recorded both preoperatively and at the final follow-up to assess the accuracy of the prosthesis placement and the prognosis of the patients.
There were no significant differences in femoral anteversion, neck-shaft angle, aMFA, or LLD between the two groups. However, the digital group showed smaller deviations between the planned and actual acetabular prosthesis angles compared to the conventional group, with shorter operative times and reduced blood loss. Follow-up Harris hip scores were significantly higher in the digital group (p < 0.05).
Digital technology enhances the accuracy and reproducibility of prosthesis placement in THA, reduces operative time and blood loss, and shows a promising potential for broader application.
尽管全髋关节置换术（THA）能有效缓解终末期髋关节疾病的疼痛并恢复关节功能，但在实现精确截骨以及最大程度减少对假体定位的主观依赖方面仍存在挑战。本研究旨在评估术前虚拟规划和导航模板与传统技术相比的有效性和安全性，为提高THA的精准度和个性化提供新方法。
在2022年至2023年期间，我们根据纳入和排除标准，对我院接受THA手术的74例患者进行了一项回顾性病例对照研究。该研究包括42例传统方法组患者，他们按照传统方法进行术前规划和手术操作；以及32例数字辅助组患者，他们使用计算机辅助虚拟术前规划和三维打印个性化导航模板辅助手术。比较两组的主要参数，包括手术时间、失血量、术后股骨前倾角、颈干角、解剖 - 机械股骨干轴线角（aMFA）、肢体长度差异（LLD）以及髋关节假体置入角度。术前和最终随访时均记录Harris髋关节评分，以评估假体置入的准确性和患者的预后。
两组之间的股骨前倾角、颈干角、aMFA或LLD无显著差异。然而，与传统组相比，数字组计划髋臼假体角度与实际角度之间的偏差更小，手术时间更短，失血量减少。随访时数字组的Harris髋关节评分显著更高（p < 0.05）。
数字技术提高了THA中假体置入的准确性和可重复性，减少了手术时间和失血量，并且显示出有广阔应用前景。
