Patient-Specific 3-Dimensional Modeling and Its Use for Preoperative Counseling of Patients Undergoing Hip Arthroscopy
Patient-Specific 3-Dimensional Modeling and Its Use for Preoperative Counseling of Patients Undergoing Hip Arthroscopy
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DOI：
10.1177/2325967118794645
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发表时间：
2018-09-11
影响因子：
2.6
通讯作者：
Giordano, Brian
中科院分区：
文献类型：
--
作者：
Childs, Sean;McVicker, Zachary;Giordano, Brian
背景：股骨髋臼撞击（FAI）代表近端股骨和髋臼骨形态的复杂改变。影像学研究对于症状性 FAI 的诊断和治疗计划至关重要，但患者的理解和满意度也有限。探索替代患者咨询方式有望提高患者理解、满意度并最终改善结果。目的：比较通过常规计算机断层扫描 (CT)、通用髋关节模型和根据患者特定解剖结构打印的 3 维 (3D) 模型进行咨询的患者对功能解剖学和 FAI 病理形态学的认知理解。证据水平，2.方法：2015 年 11 月至 2017 年 4 月期间，对经影像学确诊为 FAI 的患者进行了前瞻性随机分析。患者被随机分为接受单独 CT 成像、通用人体髋关节模型或髋关节触觉 3D 模型的术前咨询的组。所有小组都接受了一份新颖的问卷调查，以检查患者的满意度以及对与 FAI 相关的各种主题的理解。将数据与双变量和多变量分析进行比较。统计显着性确定为 P < .05。 结果：本研究纳入 31 名患者（25 名男性，6 名女性）。 10 名患者被随机分入仅 CT 组，11 名患者分入通用髋关节模型组，10 名患者接受定制的 3D 打印髋关节模型。与接受触觉 3D 模型咨询的患者相比，术前接受孤立 CT 成像或通用髋关节模型咨询的患者对其病理生理学和手术干预的作用有更深入的了解 (P = .03)。在最终随访中，与仅使用通用髋关节模型进行咨询的患者相比，接受使用孤立 CT 成像或触觉 3D 模型咨询的患者报告理解能力有更大的提高和保留 (P = .03)。结论：与单独使用 CT 成像相比，使用触觉 3D 髋关节模型进行术前咨询似乎不会对患者报告的对 FAI 的理解或满意度产生有利影响。对替代咨询手段的持续研究可能有助于进一步提高患者对这种复杂的解剖现象的理解和满意度。
Background: Femoroacetabular impingement (FAI) represents complex alterations in the bony morphology of the proximal femur and acetabulum. Imaging studies have become crucial in diagnosis and treatment planning for symptomatic FAI but also have limited patient understanding and satisfaction. Exploration of alternative patient counseling modalities holds promise for improved patient understanding, satisfaction, and ultimately for outcomes.Purpose: To compare perceived understanding of functional anatomy and FAI pathomorphology among patients counseled with routine computed tomography (CT), generic hip models, and a 3-dimensional (3D) model printed in accordance with a patient's specific anatomy.Study Design: Cohort study; Level of evidence, 2.Methods: A prospective randomized analysis of patients presenting with radiographically confirmed FAI was conducted between November 2015 and April 2017. Patients were randomized into groups that received preoperative counseling with CT imaging alone, a generic human hip model, or a haptic 3D model of their hip. All groups were subjected to a novel questionnaire examining patient satisfaction and understanding on a variety of topics related to FAI. Data were compared with bivariate and multivariate analyses. Statistical significance was determined as P < .05.Results: Thirty-one patients were included in this study (25 men, 6 women). Ten patients were randomized to the CT-only group, 11 to the generic hip model group, and 10 to receive custom 3D-printed models of their hips. Patients preoperatively counseled with isolated CT imaging or a generic hip model reported greater understanding of their pathophysiology and the role of surgical intervention when compared with those counseled with haptic 3D models (P = .03). At final follow-up, patients counseled with the use of isolated CT imaging or haptic 3D models reported greater increases and retention of understanding as compared with those counseled with generic hip models alone (P = .03).Conclusion: Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to FAI when compared with the use of CT imaging alone. Continued research into alternative counseling means may serve to further improve patient understanding and satisfaction on this complex anatomic phenomenon.