Orthosize软件在初次全髋关节置换术前测量的准确性和可靠性分析

Accuracy and reliability of preoperative templating using Orthosize software for primary total hip arthroplasty

目的 回顾性研究Orthosize软件在初次全髋关节置换(THA)术前测量的准确性及可靠性,探讨THA术前设计的必要性和重要性。方法 收集2018年1月至2020年12月荆门市中医医院符合要求的行THA的患者共63例作为研究对象。其中,男26例,女37例;年龄48~76岁,平均(64.86±7.16)岁。两个测量者均使用传统胶片模板(胶片测量法)及Orthosize软件(软件测量法)预测假体大小,记录术前测量的髋臼及股骨柄假体型号、术后测量X线假体型号。计算两种方法术前、术后测量的准确率,对比分析两种方法术前预测假体型号与实际使用型号的差异性,并且评估Orthosize软件测量法的可靠性。结果 术前预测假体型号的准确率如下:在髋臼侧胶片测量法与软件测量法相差1个型号以内分别占87.3%、95.2%(完全符合分别占60.3%、73.0%),在股骨侧胶片测量法与软件测量法相差1个型号以内分别占90.5%、96.8%(完全符合分别占65.1%、76.2%),两种方法术前测量的差异性比较有统计学意义(P<0.05),且软件测量法在髋臼侧和股骨侧均较胶片测量法准确率高。软件测量法组内及组间测量数据的可靠性良好(Kappa>0.81)。结论 Orthosize软件在THA术前设计中预测假体型号的准确性和可靠性令人满意,准确的术前测量对于髋关节的解剖重建和功能恢复具有重要的意义。

Objective To analyze the accuracy and reliability of preoperative templating using Orthosize software for primary total hip arthroplasty(THA),and discuss the necessity and importance of preoperative design of THA.Methods From January 2018 to December 2020,63 patients treated with THA in Jingmen Hospital of Traditional Chinese Medicine were studied.There were 26 males and 37 females,the age ranged from 48 to 76 years old,with an average of(64.86±7.16)years old.Two surgeons used traditional film template(film measurement method)and Orthosize software(software measurement method)to predict the prosthesis size,and recorded the size of hip prosthesis before and after surgery.We calculated the accuracy rate of the two methods preoperatively and postoperatively,compared and analyzed the difference of d-value between the predicted size and the actual size,and evaluated the reliability of Orthosize software measurement.Results In preoperative templating,the accuracy rate of the film measurement and the software measurement on the acetabular side were 87.3%and 95.2%with in±1 size(60.3%and 73.0%were completely consistent),and on the femoral side were 90.5%and 96.8%with in±1 size(65.1%and 76.2%were completely consistent).The difference of preoperative measurement between the two methods was significant(P<0.05),and the accuracy rate of the software measurement was higher than the film measurement in both acetabular and femoral side.The results showed good reproducibility with high Kappa values(Kappa>0.81),indicating good intra-and interobserver reliability.Conclusion The accuracy and reliability of Orthosize software in predicting the prosthesis size in THA preoperative planning are satisfactory.Accurate preoperative measurement is significant for hip anatomical reconstruction and functional recovery.