Nakai Takuya, Fukunishi Shigeo
Orthopedic Surgery, Nishinomiya Kaisei Hospital, Hyogo, JPN.
Cureus. 2025 Jul 13;17(7):e87865. doi: 10.7759/cureus.87865. eCollection 2025 Jul.
Background CT-based navigation systems for total hip arthroplasty (THA) have been used to prevent complications in cup placement. It has been reported that the accuracy of cup alignment, known as inclination and anteversion, has improved with the use of a navigation system. However, while cup placement height and medialization are important, there are few reports on the accuracy of cup positioning. Methods CT-based navigation was used for cup placement, and the discrepancy between preoperative planning and postoperative CT evaluation was examined in three dimensions. It was also investigated whether the degree of developmental dysplasia of the hip (DDH) (Crowe classification and double floor) made a difference in the accuracy of cup placement. Results The absolute discrepancies between preoperative plans and postoperative measurements were 1.7 (range 0-8) mm in the transverse axis, 2.3 (range 0-12) mm in the sagittal axis, and 2.2 (range 0-11) mm in the longitudinal axis. No significant variation was found in any of the three-dimensional measurements taken for all Crowe classifications, with or without the presence of an acetabular "double floor". However, the double-floor subgroup showed a trend toward greater discrepancy in all directions. Conclusions CT-based navigation systems can position the cup with high three-dimensional accuracy in primary THA without affecting acetabular deformity.
基于CT的全髋关节置换术（THA）导航系统已被用于预防髋臼杯置入的并发症。据报道，使用导航系统后，髋臼杯对线的准确性（即倾斜度和前倾角）有所提高。然而，虽然髋臼杯的置入高度和内移很重要，但关于髋臼杯定位准确性的报道却很少。方法：采用基于CT的导航系统进行髋臼杯置入，并在三维空间中检查术前规划与术后CT评估之间的差异。还研究了髋关节发育不良（DDH）的程度（Crowe分级和双髋臼底）是否对髋臼杯置入的准确性产生影响。结果：术前规划与术后测量在横轴上的绝对差异为1.7（范围0-8）mm，矢状轴上为2.3（范围0-12）mm，纵轴上为2.2（范围0-11）mm。对于所有Crowe分级，无论有无髋臼“双髋臼底”，在任何三维测量中均未发现显著差异。然而，双髋臼底亚组在所有方向上均有差异更大的趋势。结论：基于CT的导航系统在初次全髋关节置换术中能以较高的三维精度定位髋臼杯，且不影响髋臼畸形。
