手术导航系统提高全髋关节置换术中髋臼假体植入精确度的研究

Improvement of the accuracy of acetabular component placement in total hip arthroplasty by using a navigation system

目的 评价应用新型非影像手术导航系统进行非骨水泥全髋关节置换对提高术中髋臼假体植入角度精确度的影响。 方法 取 12具成人尸体 ,每例随机于一侧应用手术导航系统进行全髋关节置换髋臼假体植入 ,其对侧用传统的髋臼假体定位器植入假体。设定髋臼假体最佳植入角度为倾斜角 4 5°,前倾角 2 0°。术后用三维数字化仪测定髋臼假体植入的角度情况。 结果 手术导航系统植入的髋臼假体倾斜角为 (4 5 .5± 2 .3)°,前倾角为 (2 1.8± 2 .5 )°。传统方法植入假体的倾斜角为 (4 2 .5± 6 .3)° ,前倾角为 (2 4 .8± 7.7)°。比较两组结果 ,倾斜角的差异具有显著性意义 (P <0 .0 5 )。 结论 手术导航系统可以很好地提高术中髋臼假体植入的精确度 ,从而降低假体松动等并发症的发生。

Objective To evaluate the role of a new non-image based surgical navigation system in improving the accuracy of acetabular component in total hip arthroplasty. Methods Within the prospective study in 12 human cadavers,acetabular component implantations in total hip arthroplasty were performed. For every case,one randomly chosen side was operated on by the non-image based hip navigation system,and the other side by a conventional mechanically guided procedure. According to the design of the study,the acetabular component was placed in beat inclination of 45° and beat anteversion of 20°. Postoperative cup position was determined in both groups by using a mechanical digitizing arm (MicroScribe-3DX). Results In the navigated group,inclination and anteversion reached (45.5± 2.3)° and (21.8±2.5)° respectively. In the control group,inclination and anteversion were (42.5± 6.3)° and (24.8±7.7)°respectively. The difference of inclination was considered statistically significant ( P < 0.05 ). Conclusions More precise placement of acetabular component in the desired orientation can be achieved by the surgical hip navigation system than by the conventional techniques in the total hip arthroplasty.