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经验较少的外科医生中传统导航与基于计算机断层扫描的导航辅助偏心旋转髋臼截骨术的比较

Conventional versus computer-tomography based navigation assisted eccentric rotational acetabular osteotomy in less experienced surgeons.

作者信息

Osawa Yusuke, Takegami Yasuhiko, Funahashi Hiroto, Ido Hiroaki, Asamoto Takamune, Imagama Shiro

机构信息

Department of Orthopaedic Surgery, Nagoya University, Nagoya, Japan.

出版信息

Arch Orthop Trauma Surg. 2025 Jul 21;145(1):383. doi: 10.1007/s00402-025-05990-x.

DOI:10.1007/s00402-025-05990-x
PMID:40689976
Abstract

INTRODUCTION

The use of navigation systems may improve the preoperative planning and outcomes of less-experienced surgeons for periacetabular osteotomies. This study aimed to evaluate the clinical outcomes of conventional and navigation-guided eccentric rotational acetabular osteotomy (ERAO).

METHODS

The inclusion criteria were patients that underwent ERAO performed by less experienced surgeons (performing ERAO less than 25 cases) for hip dysplasia between January 2016 and December 2022. The study group was divided into the conventional (38 patients, 42 hips) and navigation groups (32 patients, 34 hips). Assessment tools included the operative time, blood loss, preoperative and final follow-up Harris Hip Scores (HHS), complications, and acetabular imaging parameters.

RESULTS

The study included a total of 70 patients (6 men and 64 women, average age of 35.1 years, 76 hip joints). There were no significant differences in the operative time, intraoperative blood loss, and preoperative and final HHS scores between the two groups. Complications were observed in 10 (24%) and 3 (9%) hip joints in the conventional and navigation groups, respectively. Conversion to total hip arthroplasty was performed in two hip joints (5.4%) in the conventional group and none in the navigation group. The postoperative lateral center edge angle and acetabular head index were significantly greater in the navigation group than in the conventional group.

DISCUSSION

This study demonstrated that even less experienced surgeons can reduce complications and achieve favorable acetabular coverage with ERAO using navigation systems.

摘要

引言

对于经验不足的外科医生而言,使用导航系统可能会改善髋臼周围截骨术的术前规划并提高手术效果。本研究旨在评估传统及导航引导下的偏心旋转髋臼截骨术(ERAO)的临床效果。

方法

纳入标准为2016年1月至2022年12月期间由经验不足的外科医生(进行ERAO手术少于25例)为髋关节发育不良患者实施ERAO手术的病例。研究组分为传统组(38例患者,42髋)和导航组(32例患者,34髋)。评估工具包括手术时间、失血量、术前及末次随访时的Harris髋关节评分(HHS)、并发症以及髋臼影像学参数。

结果

本研究共纳入70例患者(6例男性和64例女性,平均年龄35.1岁,76个髋关节)。两组在手术时间、术中失血量、术前及末次HHS评分方面均无显著差异。传统组和导航组分别有10个(24%)和3个(9%)髋关节出现并发症。传统组有2个髋关节(5.4%)转为全髋关节置换术,导航组无此情况。导航组术后的外侧中心边缘角和髋臼头指数显著高于传统组。

讨论

本研究表明,即使是经验不足的外科医生,使用导航系统进行ERAO手术也可减少并发症并获得良好的髋臼覆盖。

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本文引用的文献

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Unveiling the learning curve of periacetabular osteotomy.揭示髋臼周围截骨术的学习曲线。
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J Hip Preserv Surg. 2021 Feb 5;7(4):764-776. doi: 10.1093/jhps/hnab009. eCollection 2020 Dec.
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The learning curve for the direct anterior total hip arthroplasty: a systematic review.直接前路全髋关节置换术的学习曲线:系统评价。
Int Orthop. 2021 Aug;45(8):1971-1982. doi: 10.1007/s00264-021-04986-7. Epub 2021 Feb 24.
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Robotics and Navigation as Learning Tools for Fellows Training in Hip Arthroplasty.机器人技术和导航作为髋关节置换术住院医师培训的学习工具。
J Am Acad Orthop Surg. 2021 Feb 15;29(4):176-181. doi: 10.5435/JAAOS-D-20-00357.
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Outcomes of computer-assisted peri-acetabular osteotomy compared with conventional osteotomy in hip dysplasia.计算机辅助髋臼周围截骨术与传统截骨术治疗髋关节发育不良的疗效比较。
Int Orthop. 2020 Jun;44(6):1055-1061. doi: 10.1007/s00264-020-04578-x. Epub 2020 Apr 28.
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The Learning Curve in Hip Arthroscopy: Effect on Surgical Times in a Single-Surgeon Cohort.髋关节镜手术学习曲线:对单外科医生队列手术时间的影响。
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Long-Term Survivorship of Total Hip Arthroplasty with Highly Cross-Linked Polyethylene for Osteonecrosis.骨坏死患者行超交联聚乙烯全髋关节置换的长期生存情况。
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