■存在许多技术和技术用于组件定位的术中评估,腿长度,和全髋关节置换术的偏移,但比较数据有限。我们对现有文献进行了系统回顾,以评估术中评估组件位置以及腿长和偏移的准确性的技术和技术范围。精度,手术时间,成本,以及与临床结果的关系。
■对1974年至2023年的Embase和Medline数据库进行了全面搜索。我们纳入了对照或比较前瞻性临床研究。2名独立评审员使用Cochrane的随机试验偏倚风险工具和非随机研究中的偏倚风险-干预工具来评估每项研究的偏倚风险。我们对纳入的研究进行了定性和定量分析。然而,由于异质性,荟萃分析被认为不可行.
■我们的综述包括25项研究,其中52项术中技术和技术。在纳入的研究中,对机械指南和计算机导航进行了最频繁的评估。计算机导航系统在所有措施中始终显示出最高的准确性和精确度,以更长的平均手术时间为代价。相比之下,徒手技术表现出最差的准确性和精确度。在总体手术费用或临床结果的差异方面,发现数据不足,无法得出任何有意义的结论。
■证据表明,在全髋关节置换术中,计算机化的导航系统在定位组件方面最为准确和精确。需要进一步的研究来确定它们的健康和经济影响,以及导航技术的准确性和精确性在临床结果方面是否合理。
UNASSIGNED: Many techniques and technologies exist for the intraoperative assessment of component positioning, leg lengths, and offset in total hip arthroplasty, but with limited comparative data. We conducted a systematic review of the available literature to evaluate the range of techniques and technologies for the intraoperative assessment of component position as well as leg lengths and offset in terms of accuracy, precision, surgical time, cost, and relationship to clinical outcomes.
UNASSIGNED: A comprehensive search of the Embase and Medline databases from 1974 to 2023 was performed. We included controlled or comparative prospective clinical studies. Cochrane\'s risk-of-bias tool for randomized trials and Risk of Bias in Non-Randomized Studies - of Interventions tools were used by 2 independent reviewers to evaluate each study for risk of bias. We conducted both qualitative and quantitative analyses of the studies included. However, a meta-analysis was deemed not to be feasible due to heterogeneity.
UNASSIGNED: Our review included 25 studies with 52 intraoperative techniques and technologies. Mechanical guides and computerized
navigation were most frequently evaluated in the included studies. Computerized
navigation systems consistently showed the greatest accuracy and precision across all measures, at the cost of longer mean operative time. In contrast, freehand techniques demonstrated the poorest accuracy and precision. Insufficient data were found to reach any meaningful conclusions in terms of differences in overall surgical cost or clinical outcomes.
UNASSIGNED: Evidence shows that computerized
navigation systems are most accurate and precise in positioning components during total hip arthroplasty. Further research is needed to determine their health and economic impact and whether the accuracy and precision of navigated techniques are justified in terms of clinical outcomes.