■髋关节置换手术的需求正在增加,需要严格改进成熟的手术方案。术后患者的不满意主要源于术后并发症,原因是假体的选择不当以满足每位患者的需求。这会导致假体松动,医院相关骨折,术后复杂的疼痛,这都可以归因于不适当的尺寸。在这项研究中,我们旨在进一步探讨在全髋关节置换术(THA)术前计划中纳入计算机辅助设计(CAD)的术中和术后获益.
■收集2021年1月至2021年12月需要进行全髋关节置换手术的62例患者,随机分为术前计算机辅助模拟组和常规X线解释组。比较两组术前计划和手术方式之间植入物尺寸选择(股骨和髋臼植入物)的准确性。患者参数,围手术期Harris髋关节评分,手术时间(皮肤对皮肤时间),手术失血,记录术后住院时间,两组间的差异采用单样本t检验进行统计学比较。
■研究中的所有患者均成功进行了手术,并获得了良好的术后功能恢复。有了CAD,与对照组相比,选择最合适尺寸的假体明显更准确(CAD/对照组之间的髋臼组件的准确性:80.6%/61.3%,股骨组件的准确性:83.9%/67.7%)。术中失血量(177.4/231.0ml,P=0.002),手术时间(84.2±19.8min/100.3±25.9min,P=0.008),住院时间(6.5±3/9.1±3.9天,P=0.003),术后髋关节Harris评分(81.9±6.5/74.7±11.1,P=0.003)与对照组比较,差异有统计学意义。
■将CAD纳入全髋关节置换术的术前计划中,可以有效地指导选择最合适尺寸的假体,减少术中失血,促进THA后短期功能恢复。
UNASSIGNED: Hip replacement surgeries are increasing in demand, requiring rigorous improvements to a mature surgical protocol. Postoperative patient dissatisfaction mainly stems from postoperative complications resulting from the inappropriate selection of prostheses to meet the needs of each patient. This results in prosthesis loosening, hospital-related fractures, and postoperative complex pain, which can all be attributed to inappropriate sizing. In this study, we aimed to further explore the intraoperative and postoperative benefits of incorporating computer-aided design (CAD) in preoperative planning for total hip arthroplasty (THA).
UNASSIGNED: A total of 62 patients requiring total hip replacement surgery from January 2021 to December 2021 were collected and randomly divided into a preoperative computer-aided simulated group and a conventional x-ray interpretation group. The accuracy of implant size selection (femoral and acetabular implant) between the preoperative planning and surgical procedure of the two groups was compared. Patient parameters, perioperative Harris hip scores, operative time (skin-to-skin time), surgical blood loss, and postoperative hospital stay were recorded, and the differences between the two groups were statistically compared using a single sample t-test.
UNASSIGNED: All patients in the study were successfully operated on and achieved good postoperative functional recovery. With CAD, the selection of the most suitable-sized prosthesis was significantly more accurate compared to the control group (accuracy of the acetabular component between the CAD/control: 80.6%/61.3%, and accuracy of the femoral component: 83.9%/67.7%). Intraoperative blood loss (177.4/231.0 ml, P = 0.002), operation time (84.2 ± 19.8 min/100.3 ± 25.9 min, P = 0.008), duration of hospital stay (6.5 ± 3/9.1 ± 3.9 days, P = 0.003), and postoperative Harris hip score (81.9 ± 6.5/74.7 ± 11.1, P = 0.003) were compared to the control group and showed statistical significance.
UNASSIGNED: Incorporating CAD into the preoperative planning of total hip arthroplasty can effectively guide the selection of the most suitable-sized prosthesis, reduce intraoperative blood loss, and promote short-term functional recovery after THA.