数字化通用模板测量程序在全髋关节置换术中的应用

Clinical application of universal digital template system for total hip arthroplasty

目的应用自主开发的数字化通用模板测量软件进行全髋关节置换术前模板测量，评价其临床应用价值。方法髋关节疾病患者30例，交替分组（常规组15例，模板组15例）。模板组患者术前通过数字化通用模板测量程序进行术前假体比对；常规组患者仅依靠手术医师临床经验评估所用假体型号。记录手术时间、术中出血量和术前与术中假体型号匹配情况；门诊随访1年并采用髋关节Harris评分标准对两组手术疗效进行评估。结果模板组平均手术时间（46．53±7．07）min，出血量（115．33±10．05）ml；常规组手术时间（56．00±8．87）min，出血量（142．67±16．33）ml。手术时间、出血量两组间差异有统计学意义（P〈0．05）。模板组术前与术中假体型号匹配率较常规组明显提高。模板组Harris评分（84±3．42），常规组Harris评分（83±3．76），结果显示两组间差异无统计学意义（P〉0．05）。结论应用数字化通用模板测量程序进行全髋关节置换术前准备，可指导医生快速、精确地实施手术，显著提高手术的安全性。

Objective A self-developed universal digital template system was used for preopera- tional templating in total hip arthroplasty operations. Its practicality was evaluated. Methods A clinical data of 30 patients with hip diseases were divided into digital template group and control group alternative- ly. A digital template system was used to determine the prosthesis size before operation in the template group,while in control group it is completed only by surgeon＇ s experience during operation. Operative time, intra-operative blood loss and the size of the prosthesis determined preoperatively and intra-operative- ly were recorded. Harris Score was recorded during the followed up. Results The mean operative time of template system group was （46.53±7.07 ） min, the amount of bleeding was （ 115.33 ±10.05 ） ml; the mean time of the conventional surgical group was （ 56.00±8. 87 ） min, the amount of bleeding was （ 142.67±16.33 ） ml. The gap between the two groups had a significant difference （ P 〈 0.05 ）. The pros- thesis model matching rate between template system group and the conventional group on preoperative and intra-operative was raised obviously. Reexaminations of hip X-ray after operation showed that prosthesis were located in right place. All the patients were followed up in one year,the mean Harris hip score of tem- plate system group was （ 84±3.42 ） ; the conventional surgery group mean＇s was （ 83±3.76 ）, results showed that the difference between the two groups was not significant（ P 〉 0.05）. Hip varus deformity and limb shortening deformity were not found in both groups. Conclusion The universal digital template sys- tem has been proved providing a simple, effective preoperative templating to significantly improve safety and accuracy of THA surgery.