PDF(Pubmed)
Abstract：
Cerebral palsy (CP) often results in severe hip issues, disrupting musculoskeletal development and mobility due to problems such as dislocations and contractures, aggravated by spasticity and heightened muscular tone. While total hip arthroplasty (THA) is required in CP patients, the procedure carries high risks due to concerns about dislocation and wear. This study explores a method of intraoperative navigation to precisely execute preoperative strategies for spinopelvic alignment and optimal cup placement. We discuss a case of a 22-year-old male CP patient with bilateral hip dislocations who experienced significant discomfort, impeding mobility and affecting his performance as a Paralympic rower. He underwent bilateral hip replacement surgeries, guided by preoperative gait analysis and imaging, with navigation aiding in accurate acetabular component placement and correction of excessive femoral anteversion using a modular stem. The patient achieved excellent stability in both standing and rowing postures. Overall, computer navigation enhances complex hip repair by facilitating intraoperative data collection and precise execution of preoperative plans. This approach may extend the lifespan of prostheses, particularly by achieving precise acetabular component placement based on spinopelvic alignment principles, thereby offering significant benefits for CP patients undergoing THA.
摘要：
脑瘫（CP）通常会导致严重的髋关节问题，由于脱臼和挛缩等问题而破坏肌肉骨骼发育和活动，因痉挛和肌肉张力增强而加剧。虽然CP患者需要全髋关节置换术(THA),由于担心错位和磨损，该程序具有很高的风险。这项研究探索了一种术中导航方法，以精确执行术前策略，以进行脊柱骨盆对准和最佳杯放置。我们讨论了一例22岁的男性CP患者，患有双侧髋关节脱位，并经历了明显的不适，阻碍行动并影响他作为残奥会赛艇运动员的表现。他接受了双侧髋关节置换手术，在术前步态分析和成像指导下，导航帮助准确的髋臼组件放置和纠正过度的股骨前倾使用模块化的茎。患者在站立和划船姿势中均获得了出色的稳定性。总的来说,计算机导航通过促进术中数据收集和术前计划的精确执行来增强复杂的髋关节修复。这种方法可能会延长假体的寿命，特别是通过基于脊柱骨盆对齐原理实现精确的髋臼组件放置，从而为接受THA的CP患者提供显著的益处。
