Acoustic characteristics of broaching procedure for post-operative stem subsidence in cementless total hip arthroplasty
Acoustic characteristics of broaching procedure for post-operative stem subsidence in cementless total hip arthroplasty
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DOI：
10.1007/s00264-021-05278-w
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发表时间：
2022-01-03
影响因子：
2.7
通讯作者：
Ishijima, Muneaki
中科院分区：
文献类型：
--
作者：
Zhuang, Xu;Homma, Yasuhiro;Ishijima, Muneaki
目的避免股骨柄下沉是非骨水泥型全髋关节置换术（THA）获得更好疗效的关键。本研究的目的是开发一个预测模型的发生率术后柄下沉使用全定量的声学参数在锤打声在扩孔programmer.Methods的准确性进行评估，锤打声在扩孔过程中的49例患者的55个髋关节接受THA与非骨水泥锥形楔形柄进行了分析。结果股骨柄平均下沉2.15 ± 2.91mm，其中3 mm以上11髋（20%），5 mm以上7髋（12.7%）。患者的基本特征、术前股骨形态、术后即刻髓腔填充率和股骨柄对线与股骨柄下沉量无显著相关性。9个声学参数与下沉值显著相关。建立了仅用扩髓过程中的声学参数预测股骨柄术后下沉的模型，该模型对股骨柄术后下沉5 mm以上的预测值为正预测值100%，负预测值90.6%。我们的研究结果表明，我们正处于一个新时代的开始，在这个新时代中，新颖和创新的智能技术可以用于辅助骨科手术。
Purpose Avoiding stem subsidence is crucial for achieving better outcome for cementless total hip arthroplasty (THA). The aim of this study was to develop a prediction model for the incidence of post-operative stem subsidence using full quantitative acoustic parameters in hammering sound during the broaching procedure and to assess the accuracy of this prediction model.Methods The acoustic parameters of the hammering sounds during a broaching procedure for 55 hips in 49 patients who underwent THAs with cementless taper-wedged stem were analysed. The stem subsidence was assessed at one month post-operatively, and the relationship between the acoustic parameters and the value of stem subsidence was investigated.Results The average stem subsidence was 2.15 +/- 2.91 mm. The subsidence 3 mm or more was observed in eleven hips (20%), and 5 mm or more was observed in seven hips (12.7%). Basic patient's characteristics, preoperative femoral morphology and immediate post-operative canal fill ratio and stem alignment were not significantly related to the volume of stem subsidence. Nine acoustic parameters were significantly correlated with the value of subsidence. The prediction model for post-operative subsidence using only acoustic parameters during broaching procedure was established, and this model showed a positive prediction value of 100% and a negative prediction value of 90.6% for post-operative stem subsidence at 5 mm or more.Conclusion Post-operative stem subsidence can be predicted by using acoustic parameters of the hammering sound during the broaching procedure. Our results suggest that we are at the start of a new era in which novel and innovative smart technologies can be used to assist in orthopaedic surgery.