Effect of improved navigation performance on the accuracy of implant placement in total hip arthroplasty with a CT-based navigation system
Effect of improved navigation performance on the accuracy of implant placement in total hip arthroplasty with a CT-based navigation system
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DOI：
10.1007/s10047-018-1041-6
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发表时间：
2018-09-01
影响因子：
1.3
通讯作者：
Miki, Hidenobu
中科院分区：
文献类型：
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作者：
Nakahara, Ichiro;Kyo, Takayuki;Miki, Hidenobu
基于计算机断层扫描（CT）的导航系统是在全髋关节置换术（THA）中以适当的对线和位置放置植入物的支持工具之一。为了确定更高的导航性能是否会进一步提高临床环境中植入物放置的准确性，我们回顾性比较了两种不同版本导航系统的导航准确性。新版本的导航系统有一个升级的光学传感器，具有上级的位置精度。导航准确性，定义为使用较新版本导航系统进行的49例THA与使用较旧版本导航系统进行的49例THA的术后CT图像测量值和术中导航系统记录值之间的差异。对于较新版本，髋臼杯倾斜度、髋臼杯前倾度、股骨柄前倾度和股骨柄外翻角度的植入物对线平均绝对准确度（95%一致性限值）分别为1.2度（+/- 3.3度）、1.0度（+/- 2.4度）、2.0度（+/- 4.9度）和1.1度（+/- 2.4度）。种植体位置的准确度为1.5 mm（+/- 3.1 mm），1.3 mm（+/- 3.0 mm）和1.5 mm（+/- 3.1 mm），髋臼杯x轴、y轴和z轴分别为1.6 mm股骨柄x轴、y轴和z轴分别为1.4 mm（+/- 3.2 mm）、1.4 mm（+/-2.9 mm）和1.5 mm（+/- 2.7 mm），下肢长度差异为2.4 mm（+/- 4.5 mm）。与旧版本相比，新版本的值更准确，变化更小。随着导航性能的升级，在临床环境中证明了更准确的种植体放置。
A computed tomography (CT)-based navigation system is one of the support tools to place implant with appropriate alignment and position in total hip arthroplasty (THA). To determine whether the higher performance of the navigation would further improve the accuracy of implant placement in the clinical setting, we retrospectively compared the navigation accuracy of two different versions of a navigation system. The newer version of the navigation system had an upgraded optical sensor with superior positional accuracy. Navigation accuracy, defined as differences between postoperative measurements on CT images and intraoperative records on the navigation system, of 49 THAs performed with the newer version of the navigation system was compared with that of 49 THAs performed with the older version. With the newer version, the mean absolute accuracy (95% limits of agreement) of implant alignment was 1.2 degrees (+/- 3.3 degrees) for cup inclination, 1.0 degrees (+/- 2.4 degrees) for cup anteversion, 2.0 degrees (+/- 4.9 degrees) for stem anteversion, and 1.1 degrees (+/- 2.4 degrees) for stem valgus angle. The accuracy of the implant position was 1.5 mm (+/- 3.1 mm), 1.3 mm (+/- 3.0 mm), and 1.5 mm (+/- 3.1 mm) for cup x-, y-, and z-axes, respectively, 1.6 mm (+/- 3.2 mm), 1.4 mm (+/- 2.9 mm), and 1.5 mm (+/- 2.7 mm) for stem x-, y-, and z-axes, respectively, and 2.4 mm (+/- 4.5 mm) for leg length discrepancy. The values for the newer version were significantly more accurate with less variation compared to those of the older version. With upgraded navigation performance, more accurate implant placement was demonstrated in the clinical setting.