Focsa Laurentiu Cosmin, Galanzino Giacomo, Gerard Philippe, Le Strat Vincent, Lhotellier Luc, Aubert Thomas
Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France.
BMC Surg. 2025 May 15;25(1):211. doi: 10.1186/s12893-025-02950-5.
Patient-specific instrumentation for total hip arthroplasty (PSI-THA) is an emerging technology that improves the accuracy of femoral neck osteotomy and implant positioning. Unlike conventional 2D radiograph-based planning, PSI-THA leverages 3D CT reconstructions for personalized, technology-assisted positioning. This study sought to assess the intraoperative efficiency of PSI-THA in terms of surgery duration and blood loss by comparing PSI incorporating image-based guides and 3D planning with conventional surgery and 2D planning for cementless THA performed via the direct anterior approach (DAA).
Two consecutive cohorts of 100 patients each were retrospectively analysed. All patients underwent cementless THA with a straight quadrangular stem and a ceramic-on-ceramic head and liners. Two-dimensional templating was performed for the first cohort, whereas a 3D template with CT-based PSI for femoral neck osteotomy and acetabular cup positioning was performed for the second cohort. A laser guidance system was employed to increase implant placement accuracy. Operating time and intraoperative blood loss were compared between the groups.
The demographic characteristics of the two groups were comparable. The average operating time was 45.7 min (SD: 16.11) in the conventional group and 31.9 min (SD: 9.92) in the PSI group (p < 0.001). Blood loss was also significantly lower in the PSI group (319 ml) than in the conventional group (407 ml; p < 0.017).
Compared with conventional planning, PSI with 3D planning and technological assistance significantly reduced the operating time by an average of over 10 min as well as the amount of blood loss. The improved planning and execution accuracy of PSI minimizes the need for intraoperative adjustments, improves confidence in implant positioning, and reduces the need for compromises and the identification of multiple landmarks, underscoring the value of this planning technology in DAA THA.
Not applicable.
全髋关节置换术的患者特异性器械（PSI-THA）是一项新兴技术，可提高股骨颈截骨术和植入物定位的准确性。与传统的基于二维X线片的规划不同，PSI-THA利用三维CT重建进行个性化的、技术辅助的定位。本研究旨在通过比较采用基于图像的导向器和三维规划的PSI与传统手术及二维规划在直接前路（DAA）非骨水泥型THA中的手术持续时间和失血量，评估PSI-THA的术中效率。
对连续两组各100例患者进行回顾性分析。所有患者均接受了非骨水泥型THA，使用直四边形柄和陶瓷对陶瓷的股骨头及内衬。第一组进行二维模板测量，而第二组进行基于CT的PSI用于股骨颈截骨术和髋臼杯定位的三维模板测量。采用激光导向系统提高植入物放置的准确性。比较两组之间的手术时间和术中失血量。
两组的人口统计学特征具有可比性。传统组的平均手术时间为45.7分钟（标准差：16.11），PSI组为31.9分钟（标准差：9.92）（p<0.001）。PSI组的失血量（319毫升）也显著低于传统组（407毫升；p<0.017）。
与传统规划相比，采用三维规划和技术辅助的PSI显著缩短了平均手术时间超过10分钟，并减少了失血量。PSI改进的规划和执行准确性最大限度地减少了术中调整的需要，提高了对植入物定位的信心，并减少了妥协和识别多个标志点的需要，突出了该规划技术在DAA THA中的价值。
不适用。
