Developmental dysplasia of the hip(DDH)poses significant challenges in both childhood and adulthood,affecting up to 10 per 1000 live births in the United Kingdom and United States.While newborn screening aims to detec...Developmental dysplasia of the hip(DDH)poses significant challenges in both childhood and adulthood,affecting up to 10 per 1000 live births in the United Kingdom and United States.While newborn screening aims to detect DDH early,missed diagnoses can lead to severe complications such as hip dysplasia and early onset osteoarthritis in adults.Treatment options range from less invasive procedures like hip-preserving surgery to more extensive interventions such as total hip arthroplasty(THA),depending on the severity of the condition.Preoperative planning plays a critical role in optimizing surgical outcomes for DDH patients undergoing THA.This includes accurate imaging modalities,precise measurement of acetabular bone stock,assessment of femoral head subluxation,and predicting prosthesis size and leg length discrepancy.Recent advancements artificial intelligence and machine learning offer promising tools to enhance preoperative planning accuracy.However,challenges remain in validating these technologies and integrating them into clinical practice.This editorial highlights the importance of ongoing research to refine preoperative strategies and improve outcomes in DDH management through evidence-based approaches and technological innovations.展开更多
目的探究人工智能(artificial intelligence,AI)人工全髋关节置换术(total hip arthroplasty,THA)术前规划系统(AIHIP系统)辅助THA治疗成人CroweⅣ型先天性髋关节发育不良(developmental dysplasia of the hip,DDH)的近期疗效。方法回...目的探究人工智能(artificial intelligence,AI)人工全髋关节置换术(total hip arthroplasty,THA)术前规划系统(AIHIP系统)辅助THA治疗成人CroweⅣ型先天性髋关节发育不良(developmental dysplasia of the hip,DDH)的近期疗效。方法回顾分析2019年5月—2020年12月收治的23例符合选择标准的CroweⅣ型DDH患者临床资料。其中男3例,女20例;年龄44~74岁,平均52.65岁。术前双下肢长度差绝对值(15.17±22.17)mm。术前Harris评分为(62.4±7.2)分。采用AIHIP系统进行术前规划,手术均采用常规后外侧入路下THA,13例术中复位困难患者联合行股骨转子下短缩截骨术(subtrochanteric shortening osteotomy,SSOT)。记录患者手术时间、住院时间及不良事件发生情况;术前1 d及术后1周、6个月采用Harris评分评价患肢功能;术后1 d摄骨盆正位X线片评价假体位置;根据术中应用假体型号与术前规划是否一致评价假体匹配程度。结果术后髋臼杯型号与术前规划匹配程度为完全匹配16例、一般匹配4例(+1号1例、–1号3例)、不匹配3例(均为+2号),符合率为86.96%;股骨柄型号匹配程度为完全匹配22例、一般匹配1例(–1号),符合率为100%。1例术中发生股骨假体周围骨折,术中予以钢缆捆绑固定,术后6周下地助行器辅助下行走;其余患者均在术后1 d即下地助行器辅助下行走。手术时间185~315 min,平均239.43 min;住院时间8~20 d,平均9.96 d;脱离助行器时间2~56 d,平均5.09 d。术后患者均获随访6个月。患者切口均Ⅰ期愈合,无感染、脱位、再骨折、下肢深静脉血栓形成等并发症发生;术后1 d及6个月复查X线片示髋臼与股骨假体均固定牢靠且在安全范围;术后1 d双下肢长度差绝对值(11.96±13.48)mm,与术前比较差异无统计学意义(t=0.582,P=0.564)。术后6个月截骨均愈合良好。术后1周及6个月Harris评分分别为(69.5±4.9)分和(79.2±5.7)分,手术前后各时间点间比较差异均有统计学意义(展开更多
文摘Developmental dysplasia of the hip(DDH)poses significant challenges in both childhood and adulthood,affecting up to 10 per 1000 live births in the United Kingdom and United States.While newborn screening aims to detect DDH early,missed diagnoses can lead to severe complications such as hip dysplasia and early onset osteoarthritis in adults.Treatment options range from less invasive procedures like hip-preserving surgery to more extensive interventions such as total hip arthroplasty(THA),depending on the severity of the condition.Preoperative planning plays a critical role in optimizing surgical outcomes for DDH patients undergoing THA.This includes accurate imaging modalities,precise measurement of acetabular bone stock,assessment of femoral head subluxation,and predicting prosthesis size and leg length discrepancy.Recent advancements artificial intelligence and machine learning offer promising tools to enhance preoperative planning accuracy.However,challenges remain in validating these technologies and integrating them into clinical practice.This editorial highlights the importance of ongoing research to refine preoperative strategies and improve outcomes in DDH management through evidence-based approaches and technological innovations.
