摘要
目的探讨计算机三维术前计划在CroweⅣ型髋关节发育不良全髋关节置换髋臼重建中的应用可行性和准确性。方法2009年9月至2011年2月接受全髋关节置换的CroweIV型髋关节发育不良20例（20髋）纳入研究。术前应用Mimics软件模拟全髋关节置换术中的臼杯植入过程，预测臼杯大小、臼杯外展角、旋转中心位置、臼杯覆盖率和结构性植骨人数，预测结果与传统胶片模板法和术后实际结果进行比较。结果应用计算机三维技术进行术前计划，70％（14／20）的臼杯预测型号与实际型号一致，30％（6／20）相差一个型号；胶片模板法，25％（5／20）的臼杯预测型号与实际型号一致，45％（9／20）相差一个型号，30％（6／20）相差两个及以上型号。计算机三维术前计划的准确率高于胶片模板法（t=4．66，P=0．00）。应用计算机三维术前计划预测的臼杯外展角（41．10°±4．87°）、髋臼旋转中心位置[水平距离（77．51±7．78）mm，垂直距离（42．79±8．22）mm]和臼杯覆盖率（77．73％±10．51％）准确性较高，与术后实际比较差异无统计学意义[实际外展角44．98°±10．83°，t=0．88，P=0．42；实际水平距离（79．85±8．61）mm，t=1．95，P=0．11；实际垂直距离（45．30±4．60）mm，t=-1．27，P=0．26；实际臼杯覆盖率78．98％±10．24％，t=1．84，P=0．09]。5例患者经术前预测需行结构性植骨，与术后结果一致。结论对CroweIV型关节发育不良需行全髋关节置换者采用Mimics软件进行术前三维计划，能够提高臼杯型号选择和植入位置判断的准确性。
Objective To study whether 3D computerized pre-operative planning is accuracy and reliability in Crowe Ⅳ type developmental dysplasia of the hip （DDH） patients undergoing total hip arthroplasty （THA）. Methods Between September 2009 and February 2011, 20 Crowe Ⅳ type DDH patients （20 hips） were included in this study. The 3D pre-operative planning was performed using Mimics software to predict the acetabular component size, acetabular component abduction angle, hip rotation center position, the acetabular component coverage and number of patients received structural bone graft. The results were compared with traditional acetate templating technique and post-operative results. Results 70% （14/20） components were pre- dicted exactly and 30% （6/20） components were predicted with one size using 3D computerized planning, comparing with 25%（5/ 20） components were exactly, 45% （9/20） components were with one size and 30% （6/20） were with two size or more using conven- tional acetate templating technique. Statistically analysis revealed that 3D planning was more accuracy than templating technique regarding acetabular component prediction （t=-4.66, P=0.00）. There was no significant difference between the 3D computerized planned acetabular component abduction angle （3D plan 41.10°±4.87°, postoperative 44.98°±10.83°, t=0.88, P=0.42）, hip rota- tion center distance （horizontal distance： 3D plan 77.51±7.78 mm, postoperative 79.85±8.61 mm, t=-1.95, P=0.11; vertical distance： 3D plan 42.79±8.22 mm, postoperative 44.98±10.83 ram, t=-1.27, P=0.26）, acetabular component host coverage （3D plan 77.73%±10.51%, postoperative 78.98%±10.24%, t=-1.84, P=0.09）, and that found post-operatively. Five patients were consid- ered to need structural bone graft according to 3D computerized planning, which was highly coincident with the intraoperative find- ings in all five cases. Conclusion 3D computerized pre-operative planning using Mimics software is an accurate and reliable t
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2014年第12期1212-1218,共7页
Chinese Journal of Orthopaedics
基金
2013卫生行业项目（201302007）
关键词
髋脱位
先天性
关节成形术
置换
髋
成像
三维
Hip dislocation, congenital
Arthroplasty, replacement, hip
Imaging, three-dimensional
