摘要
[目的]评价初次全髋置换(total hip arthroplasty,THA)术前数字影像虚拟的临床意义。[方法]2017年8月—2021年6月在本院行初次THA患者60例纳入本研究。依据医患沟通结果,30例采用术前虚拟THA,30例采用常规THA。比较两组围手术期、随访和影像学指标。[结果]两组患者均顺利完成手术,无严重并发症。虚拟组手术时间[(97.3±20.5)min vs(131.2±19.3)min,P<0.05]、术中失血量[(245.2±20.4)ml vs(322.1±25.6)ml,P<0.05]、下地行走时间[(5.2±4.4)d vs(9.2±3.7)d,P<0.05]均显著优于常规组。两组随访时间平均(14.2±3.6)个月,虚拟组恢复完全负重活动时间显著早于常规组[(10.3±2.2)周vs(14.2±4.2)周,P<0.05]。随时间推移,两组患者Harris评分、髋关节伸屈ROM均显著增加(P<0.05),VAS评分显著减少(P<0.05)。末次随访时,虚拟组在Harris评分[(93.2±10.9)vs(81.2±8.5),P<0.05]、髋伸-屈ROM[(84.5±11.2)°vs(71.6±11.4)°,P<0.05]显著优于常规组。影像方面,虚拟组术后髋臼假体外翻角[(45.6±3.6)°vs(40.1±3.3)°,P<0.05]和前倾角[(14.1±2.5)°vs(10.1±2.1)°,P<0.05]均显著优于常规组。此外,术后虚拟组纵向HCOR[(2.2±1.7)mm vs(5.2±3.1)mm,P<0.05]和横向HCOR[(3.3±1.6)mm vs(4.9±3.1)mm,P<0.05]显著优于常规组(P<0.05),但LLD的差异无统计学意义(P>0.05)。此外,虚拟组股骨柄假体位置[中置/偏置,(28/2)vs(21/9),P<0.05]及大小[适当/偏小,(29/1)vs(23/7),P<0.05]显著优于常规组。[结论]术前数字影像虚拟规划可减少全髋关节置换手术创伤,有效提高假体匹配的准确性,促进患者术后早期髋关节功能恢复。
[Objective]To evaluate the clinical significance of digital virtual planning(DVP)before primary total hip arthroplasty(THA).[Methods]A total of 60 patients who were undergoing primary THA in our hospital from August 2017 to June 2021 were included in this study.According to the doctor-patient communication,30 patients received the DVP THA,while the remaining 30 patients received conventional THA.The perioperative period,follow-up and imaging data were compared between the two groups.[Results]All patients in both groups had THA performed successfully with no serious complications.The DVP group proved significantly superior to the conventional group in terms of operative time[(97.3±20.5)min vs(131.2±19.3)min,P<0.05],intraoperative blood loss[(245.2±20.4)ml vs(322.1±25.6)ml,P<0.05]and postoperative ambulation[(5.2±4.4)days vs(9.2±3.7)days,P<0.05].All of them were followed up for(14.2±3.6)months on a mean,the DVP group resumed full weight-bearing activities significantly earlier than the conventional group[(10.3±2.2)weeks vs(14.2±4.2)weeks,P<0.05].The Harris score and hip flexion-extension range of motion(ROM)significantly increased(P<0.05),while the VAS score significantly decreased in both groups over time(P<0.05).The DVP group proved significantly better than the conventional group at the latest follow-up in terms of Harris score[(93.2±10.9)vs(81.2±8.5),P<0.05]and hip ROM[(84.5±11.2)°vs(71.6±11.4)°,P<0.05].Radio-graphically,the DVP group got significantly more proper postoperative acetabular abduction[(45.6±3.6)°vs(40.1±3.3)°,P<0.05]and ante-version of the acetabular component[(14.1±2.5)°vs(10.1±2.1)°,P<0.05],with significantly less deviations of hip center of rotation(HCOR)longitudinally[(2.2±1.7)mm vs(5.2±3.1)mm,P<0.05]and transversely[(3.3±1.6)mm vs(4.9±3.1)mm,P<0.05]than the conventional group.In addition,the DVP group gained significantly accurate femoral component in position[medium/displaced,(28/2)vs(21/9),P<0.05]and size[appropriate/small,(29/1)vs(23/7),P<0.05]than the convention
作者
吴健
江建平
冯孝志
张昌奕
焦庆丰
丁文斌
WU Jian;JIANG Jian-ping;FENG Xiao-zhi;ZHANG Chang-yi;JIAO Qing-feng;DING Wen-bin(Department of Orthopedics,Tongling Municipal Hospital,Tongling 244000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2023年第19期1742-1747,共6页
Orthopedic Journal of China
基金
2021年铜陵市卫生健康委科研项目(编号:09)。
关键词
全髋关节置换
术前规划
数字影像虚拟
临床结果
total hip arthroplasty
preoperative planning
digital imaging virtual planning
clinical results
