Abstract：
Advancements in three-dimensional (3D) preoperative planning tools can offer surgeons and design engineers detailed feedback and additional opportunities for clinical advancements. The objective of this study is to use a 3D total hip arthroplasty preoperative planning tool to compare femoral component alignment for three different stem systems. The planning tool in this study used morphology data of femoral bones gathered from a CT database, seven from postoperative patients and 63 from statistical shape models (SSMs), to suggest specific implant sizes and optimal placements in 3D to match each specific bone model. Retrospective validations of predicted stem size and femoral version were first performed by comparing planner-chosen and surgeon-implanted stem sizes and version angles for the seven postoperative patients. Next, the alignment of three different stem systems was evaluated using bone models generated from SSMs, with a quantitative focus on component head positioning. In the validation study, the planner accurately selected stem size and orientation compared to the surgeon for all assessed subjects. In the stem evaluation, the three stem systems yielded different accuracies in component placement, with the newest stem system demonstrating the closest restoration of anatomical head center location. It is evident that new stem designs may have the potential for increased accuracy over their predecessors, demonstrating that new stem designs can offer improved intraoperative and postoperative alignment potential. The 3D preoperative planning tools can provide novel and reliable data to both surgeons and design engineers, which can ultimately improve clinical outcomes and future implant designs.
摘要：
三维（3D）术前计划工具的进步可以为外科医生和设计工程师提供详细的反馈以及更多的临床进步机会。这项研究的目的是使用3D全髋关节置换术术前计划工具来比较三种不同茎系统的股骨组件对准。这项研究中的计划工具使用了从CT数据库收集的股骨形态学数据，7名来自术后患者，63名来自统计形状模型(SSM)，建议特定的植入物尺寸和3D中的最佳放置，以匹配每个特定的骨骼模型。首先通过比较7名术后患者的计划者选择和外科医生植入的茎大小和版本角度，对预测的茎大小和股骨版本进行了回顾性验证。接下来,使用从SSM生成的骨模型评估三个不同的茎系统的对齐，定量关注组件头定位。在验证研究中，与所有评估对象的外科医生相比，计划者准确选择了茎的大小和方向。在茎评估中，这三个杆系统在组件放置方面产生了不同的精度，最新的茎系统展示了最接近的解剖头中心位置的恢复。很明显，新的阀杆设计可能有可能比以前的产品提高精度，证明新的茎设计可以提供改善的术中和术后对齐潜力。3D术前计划工具可以为外科医生和设计工程师提供新颖可靠的数据，这最终可以改善临床结果和未来的植入物设计。
