目的:探讨AI-HIP辅助手术规划系统在初次单侧全髋关节置换术(total hip arthroplasty,THA)中的规划效果及其临床结果。方法:回顾性分析2022年3月至2022年11月连续性应用AI-HIP系统行初次单侧THA的36例患者的临床资料,男16例,女20例,年龄...目的:探讨AI-HIP辅助手术规划系统在初次单侧全髋关节置换术(total hip arthroplasty,THA)中的规划效果及其临床结果。方法:回顾性分析2022年3月至2022年11月连续性应用AI-HIP系统行初次单侧THA的36例患者的临床资料,男16例,女20例,年龄43~81(62.2±10.9)岁,将其纳入AI-HIP组;根据配对原则选择同期采用传统模板方法规划的患者36例,男16例,女20例,年龄40~80(60.9±12.1)岁,作为对照组。比较两组假体的准确率,以及术前规划和术后实际联合偏心距差值、下肢长度差值、距小转子上缘截骨高度和顶肩距以评价规划效果,采用Harris评分和疼痛视觉模拟评分(visual analogue scale,VAS)评价其临床疗效。结果:两组均获得随访,时间12~18(14.5±2.1)个月。AI-HIP组规划髋臼杯和股骨柄假体型号的完全准确率、近似准确率分别为72.2%、100%和58.3%、88.9%,均优于对照组的44.4%、83.3%和33.3%、66.7%(P<0.05);规划股骨头假体型号差异无统计学意义(P>0.05)。AI-HIP组术后实际联合偏心距差值、联合偏心距差值(实际-规划)分别为1.0(0.2,2.4)mm、1.1(-2.1,3.2)mm,优于对照组的3.0(1.4,4.9)mm、3.5(-1.6,6.5)mm(P<0.05)。两组间术后实际距小转子上缘截骨高度比较,差异无统计学意义(P>0.05)。AI-HIP组术后实际下肢长度差值、下肢长度差值(实际-规划)、距小转子上缘截骨高度(实际-规划)、术后实际顶肩距、顶肩距差值(实际-规划)分别为1.5(0.2,2.8)、1.1(-0.3,2.2)、2.1(-2.3,4.1)、(15.3±4.1)、-2.2(-4.8,0.3)mm,优于对照组的2.6(1.3,4.1)、2.5(0.3,3.8)、5.8(-2.4,7.7)、(13.0±4.3)、-5.7(-9.4,-2.2)mm(P<0.05)。末次随访,两组Harris评分中功能、疼痛、功能、畸形、总分及VAS比较,差异均无统计学意义(P>0.05);而AI-HIP组Harris评分中活动度评分(4.8±0.6)分,高于对照组(4.4±0.8)分(P<0.05)。结论:AI-HIP辅助手术规划系统较传统模板规划,在初次单侧THA中对髋臼杯和股骨柄假体型号的预测、恢复联合偏心距、规划下肢长度、截骨高度和顶肩距方面具有良好的准确性,临床效果满意。展开更多
Introduction: Total hip arthroplasty of complex morphology is a challenge for the orthopaedic surgeon. Careful analysis of the hip’s anatomy helps to unravel the difficulties and anticipate the procedures to be perfo...Introduction: Total hip arthroplasty of complex morphology is a challenge for the orthopaedic surgeon. Careful analysis of the hip’s anatomy helps to unravel the difficulties and anticipate the procedures to be performed and the implants to be planned. The aim was to identify the types of hip that make first-line THR difficult, specify the technical procedures to be used on these sites, and assess the functional results of the series. Material and Methods: This was a retrospective study that concerned patients operated on for total hip arthroplasty between January 2015 and December 2022 at the medical center “La Grâce” in Bobo-Dioulasso, Burkina Faso. Patients with coxarthrosis (on hip dysplasia, acetabular protrusio, acetabular malunion or neurological hip) and those with ankylosis of the hip, osteonecrosis secondary to neglected dislocation of the hip or hemoglobinopathy were included. Results: A total of 31 total hip replacements were performed in 30 patients. The mean age of patients at the surgery time was 36.2 years with extremes of 17 and 61 years. The male-to-female sex ratio was 1. The main indications for THA were the dysplasic hip osteoarthritis (11 cases) and the neglected hip dislocations (7 cases). In situ femoral neck osteotomy before hip dislocation was performed in seven cases. The acetabulum reconstruction techniques varied from the structural iliac bone graft (n = 3) and cancellous bone graft (n = 4) to the Kerboull plate (n = 1). After 45 months of mean follow-up, all hips were evaluated. The mean PMA score increased from 7.1 [4 - 8] before the surgery to 13.2 [13 - 17]. Conclusion: The large spectrum of challenges in complex hip management requires effective preoperative planning. Preoperative planning minimizes complications and ensures a better outcome.展开更多
Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip hemiarthroplasty in Gabon. ...Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip hemiarthroplasty in Gabon. Method: It was a retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion and intraoperative data. The primary outcome was intraoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 97 patients included, the average age was 74.2 years ± 10, male predominance was 73.2%, the average ASA score was 1.9 ± 0.5, and transfusion incidence was 38.1%. The average number of RBCs transfused was 1.2 ± 0.6. Tranexamic acid was used in 11.3% of patients. The average bleeding was 450 ± 453 ml. Preoperative anemia was predictor of transfusion to be significant. Conclusion: The incidence of transfusion is law compared to total hip arthroplasty. The implementation of a patient blood management protocol is difficult given the urgency of bone repair. However, a better use of tranexamic acid could reduce this transfusion incidence.展开更多
Background: The choice of the appropriate operative intervention in patients with late and neglected hip fracture continuous to be a huge dilemma for orthopedic surgeons. Purpose: To evaluate the satisfaction or other...Background: The choice of the appropriate operative intervention in patients with late and neglected hip fracture continuous to be a huge dilemma for orthopedic surgeons. Purpose: To evaluate the satisfaction or otherwise of some treatment options using the modified Harris-hip score (HHS) in resource poor setting. Materials and Methods: A retrospective cross-sectional study conducted at ATBUTH, Bauchi. Data of 60 patients over the age of 18 years with hip fractures (femoral neck, intertrochanteric and sub trochanteric fractures) who had operative intervention between 1st September 2019 and 31st August 2020 with cannulated screws, Proximal femur lock compression plate (PFLCP), cementlessor cemented bipolar hemiarthroplasty (BHA). Results: The mean age of studied patients was 65.7 ± 16.1 years, with age ranging from 19 - 101 years. M:F ratio was 1.2:1 across all age groups and 1:1.4 amongst those >60 years. 51 patients (85%) presented > 1 week after injury with 24 patients (40%) sustaining hip fractures from low energy trivial indoor fall and 28 patients (46.7%) mostly younger sustaining fractures from high energy motor vehicular accident (MVA). The prevalence rate for femoral neck, intertrochanteric and subtrochanteric fractures were 32 (53.3%), 17 (28.3%) and 11 (18.3%) respectively. From the data retrieved, 21patients (35.0%), 17 patients (28.3%), 20 patients (33.3%) and 2 patients (3.3%) had PFLCP, cemented BHA, cementless BHA and cannulated screw fixation respectively. Most (66.7%) of those who had PFLCP achieved satisfactory radiologic union and there was also 94.1% and 85% satisfactory outcome rate amongst the patients with cemented BHA and cementless BHA respectively. Irrespective of the operative intervention method at 1 year follow-up, there was a statistically significant improvement in post-operative HHS (P value 0.02), with 83.4% having good to excellent results. Conclusion: There is highrate of late and neglected hip fracture in our environment. Satisfactory outcome with statistically significant improvement in Post-operative HHS was achieved in patients treated for hip fractures.展开更多
The compatibitily and morphology of HIPS/PC and HIPS g GMA/PC blends were studied.The compatibility and morphology of HIPS/PC blends were characterized by DSC and SEM,respectively.The result of DSC shows that T g of P...The compatibitily and morphology of HIPS/PC and HIPS g GMA/PC blends were studied.The compatibility and morphology of HIPS/PC blends were characterized by DSC and SEM,respectively.The result of DSC shows that T g of PS doesn’t change with the blend composition,and T g of PC decreases with the increase in weight fraction of HIPS,which indicates that the PC/HIPS blend is a partially miscible system.Results of SEM indicate that the decrease in T g of PC results from PS interpenetrating into the phase of PC,and no change in T g of PS results from PC not interpenetrating into the phase of PS.The copolymer of HIPS g GMA was prepared by reactive grafting method.The IR spectrum shows that GMA is grafted on the chain of HIPS.The compatibility and morphology of HIPS g GMA(35)/PC(65) were studied by DSC and SEM.PC(65)/HIPS g GMA(35) blend exhibits reduced size of disperse phase,enhanced interface adhesion and lower T g of PC phase as compared with the PC(65)/HIPS(35) blend.It implies that HIPS g GMA is an effective compatibilizer of the HIPS/PC blend.展开更多
文摘目的:探讨AI-HIP辅助手术规划系统在初次单侧全髋关节置换术(total hip arthroplasty,THA)中的规划效果及其临床结果。方法:回顾性分析2022年3月至2022年11月连续性应用AI-HIP系统行初次单侧THA的36例患者的临床资料,男16例,女20例,年龄43~81(62.2±10.9)岁,将其纳入AI-HIP组;根据配对原则选择同期采用传统模板方法规划的患者36例,男16例,女20例,年龄40~80(60.9±12.1)岁,作为对照组。比较两组假体的准确率,以及术前规划和术后实际联合偏心距差值、下肢长度差值、距小转子上缘截骨高度和顶肩距以评价规划效果,采用Harris评分和疼痛视觉模拟评分(visual analogue scale,VAS)评价其临床疗效。结果:两组均获得随访,时间12~18(14.5±2.1)个月。AI-HIP组规划髋臼杯和股骨柄假体型号的完全准确率、近似准确率分别为72.2%、100%和58.3%、88.9%,均优于对照组的44.4%、83.3%和33.3%、66.7%(P<0.05);规划股骨头假体型号差异无统计学意义(P>0.05)。AI-HIP组术后实际联合偏心距差值、联合偏心距差值(实际-规划)分别为1.0(0.2,2.4)mm、1.1(-2.1,3.2)mm,优于对照组的3.0(1.4,4.9)mm、3.5(-1.6,6.5)mm(P<0.05)。两组间术后实际距小转子上缘截骨高度比较,差异无统计学意义(P>0.05)。AI-HIP组术后实际下肢长度差值、下肢长度差值(实际-规划)、距小转子上缘截骨高度(实际-规划)、术后实际顶肩距、顶肩距差值(实际-规划)分别为1.5(0.2,2.8)、1.1(-0.3,2.2)、2.1(-2.3,4.1)、(15.3±4.1)、-2.2(-4.8,0.3)mm,优于对照组的2.6(1.3,4.1)、2.5(0.3,3.8)、5.8(-2.4,7.7)、(13.0±4.3)、-5.7(-9.4,-2.2)mm(P<0.05)。末次随访,两组Harris评分中功能、疼痛、功能、畸形、总分及VAS比较,差异均无统计学意义(P>0.05);而AI-HIP组Harris评分中活动度评分(4.8±0.6)分,高于对照组(4.4±0.8)分(P<0.05)。结论:AI-HIP辅助手术规划系统较传统模板规划,在初次单侧THA中对髋臼杯和股骨柄假体型号的预测、恢复联合偏心距、规划下肢长度、截骨高度和顶肩距方面具有良好的准确性,临床效果满意。
文摘Introduction: Total hip arthroplasty of complex morphology is a challenge for the orthopaedic surgeon. Careful analysis of the hip’s anatomy helps to unravel the difficulties and anticipate the procedures to be performed and the implants to be planned. The aim was to identify the types of hip that make first-line THR difficult, specify the technical procedures to be used on these sites, and assess the functional results of the series. Material and Methods: This was a retrospective study that concerned patients operated on for total hip arthroplasty between January 2015 and December 2022 at the medical center “La Grâce” in Bobo-Dioulasso, Burkina Faso. Patients with coxarthrosis (on hip dysplasia, acetabular protrusio, acetabular malunion or neurological hip) and those with ankylosis of the hip, osteonecrosis secondary to neglected dislocation of the hip or hemoglobinopathy were included. Results: A total of 31 total hip replacements were performed in 30 patients. The mean age of patients at the surgery time was 36.2 years with extremes of 17 and 61 years. The male-to-female sex ratio was 1. The main indications for THA were the dysplasic hip osteoarthritis (11 cases) and the neglected hip dislocations (7 cases). In situ femoral neck osteotomy before hip dislocation was performed in seven cases. The acetabulum reconstruction techniques varied from the structural iliac bone graft (n = 3) and cancellous bone graft (n = 4) to the Kerboull plate (n = 1). After 45 months of mean follow-up, all hips were evaluated. The mean PMA score increased from 7.1 [4 - 8] before the surgery to 13.2 [13 - 17]. Conclusion: The large spectrum of challenges in complex hip management requires effective preoperative planning. Preoperative planning minimizes complications and ensures a better outcome.
文摘Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip hemiarthroplasty in Gabon. Method: It was a retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion and intraoperative data. The primary outcome was intraoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 97 patients included, the average age was 74.2 years ± 10, male predominance was 73.2%, the average ASA score was 1.9 ± 0.5, and transfusion incidence was 38.1%. The average number of RBCs transfused was 1.2 ± 0.6. Tranexamic acid was used in 11.3% of patients. The average bleeding was 450 ± 453 ml. Preoperative anemia was predictor of transfusion to be significant. Conclusion: The incidence of transfusion is law compared to total hip arthroplasty. The implementation of a patient blood management protocol is difficult given the urgency of bone repair. However, a better use of tranexamic acid could reduce this transfusion incidence.
文摘Background: The choice of the appropriate operative intervention in patients with late and neglected hip fracture continuous to be a huge dilemma for orthopedic surgeons. Purpose: To evaluate the satisfaction or otherwise of some treatment options using the modified Harris-hip score (HHS) in resource poor setting. Materials and Methods: A retrospective cross-sectional study conducted at ATBUTH, Bauchi. Data of 60 patients over the age of 18 years with hip fractures (femoral neck, intertrochanteric and sub trochanteric fractures) who had operative intervention between 1st September 2019 and 31st August 2020 with cannulated screws, Proximal femur lock compression plate (PFLCP), cementlessor cemented bipolar hemiarthroplasty (BHA). Results: The mean age of studied patients was 65.7 ± 16.1 years, with age ranging from 19 - 101 years. M:F ratio was 1.2:1 across all age groups and 1:1.4 amongst those >60 years. 51 patients (85%) presented > 1 week after injury with 24 patients (40%) sustaining hip fractures from low energy trivial indoor fall and 28 patients (46.7%) mostly younger sustaining fractures from high energy motor vehicular accident (MVA). The prevalence rate for femoral neck, intertrochanteric and subtrochanteric fractures were 32 (53.3%), 17 (28.3%) and 11 (18.3%) respectively. From the data retrieved, 21patients (35.0%), 17 patients (28.3%), 20 patients (33.3%) and 2 patients (3.3%) had PFLCP, cemented BHA, cementless BHA and cannulated screw fixation respectively. Most (66.7%) of those who had PFLCP achieved satisfactory radiologic union and there was also 94.1% and 85% satisfactory outcome rate amongst the patients with cemented BHA and cementless BHA respectively. Irrespective of the operative intervention method at 1 year follow-up, there was a statistically significant improvement in post-operative HHS (P value 0.02), with 83.4% having good to excellent results. Conclusion: There is highrate of late and neglected hip fracture in our environment. Satisfactory outcome with statistically significant improvement in Post-operative HHS was achieved in patients treated for hip fractures.
文摘The compatibitily and morphology of HIPS/PC and HIPS g GMA/PC blends were studied.The compatibility and morphology of HIPS/PC blends were characterized by DSC and SEM,respectively.The result of DSC shows that T g of PS doesn’t change with the blend composition,and T g of PC decreases with the increase in weight fraction of HIPS,which indicates that the PC/HIPS blend is a partially miscible system.Results of SEM indicate that the decrease in T g of PC results from PS interpenetrating into the phase of PC,and no change in T g of PS results from PC not interpenetrating into the phase of PS.The copolymer of HIPS g GMA was prepared by reactive grafting method.The IR spectrum shows that GMA is grafted on the chain of HIPS.The compatibility and morphology of HIPS g GMA(35)/PC(65) were studied by DSC and SEM.PC(65)/HIPS g GMA(35) blend exhibits reduced size of disperse phase,enhanced interface adhesion and lower T g of PC phase as compared with the PC(65)/HIPS(35) blend.It implies that HIPS g GMA is an effective compatibilizer of the HIPS/PC blend.
