Acetabular cup placement in navigated and non-navigated total hip arthroplasty (THA): results of two consecutive series using a cementless short stem.
Acetabular cup placement in navigated and non-navigated total hip arthroplasty (THA): results of two consecutive series using a cementless short stem.
复制标题
导航和非导航全髋关节置换术 (THA) 中的髋臼杯放置：使用非骨水泥短柄的连续两个系列的结果。
DOI：
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发表时间：
2014
影响因子：
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通讯作者：
Porameth Chaiwirattana
中科院分区：
文献类型：
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作者：
Yingyong Suksathien;R. Suksathien;Porameth Chaiwirattana
背景
在接受全髋关节置换术（THA）的患者中，髋臼假体错位与脱位、撞击、骨盆骨质溶解、髋臼杯移位、下肢不等长和聚乙烯磨损的发生率增加有关。
目的
比较两个连续的短柄非骨水泥型THA系列中使用和不使用无图像导航的髋臼部件定位和手术时间。
材料和方法
回顾性研究包括31例非导航（NNAV）短柄非骨水泥型THA和30例导航（NAV）短柄非骨水泥型THA。所有病例均于术后2个月或以后进行CT扫描。采用t检验比较两组术后CT测量的外展角和前倾角。在0.05的显著性水平下，使用卡方检验比较每组安全区内髋臼杯放置（外展、前倾和组合）的百分比。两组手术时间比较采用t检验。
结果
NNAV组的平均外展为43.97（范围，33-52，SD 4.44），NAV组为41.37（范围，37-45，SD 2.01）。该差异具有显著性（p = 0.004）。NNAV组的平均前倾为22.58（范围，2-39，SD 10.68），NAV组为13.57（范围，7-18，SD 3.28）。这种差异是显著的（p < 0.001）。根据Lewinnek等的标准，NNAV组中96.8%的患者外展放置在安全区内，51.6%的患者前倾放置在安全区内，48.4%的患者外展和前倾均放置在安全区内。在NAV组中，所有30个髋臼杯（100%）均放置在安全区内进行外展、前倾和两者。两组之间，前倾角（p < 0.001）、外展和前倾角（p < 0.001）的髋臼杯放置在安全区内的百分比存在显著差异，但外展（p = 0.32）不显著。NNAV和NAV组的平均手术时间分别为107.09和110.67分钟，差异不显著（p = 0.49）。
结论
本研究表明，与徒手技术相比，使用无图像导航在安全区内放置髋臼杯的数量显著增加，尤其是在前倾角时。
BACKGROUND
Acetabular component malposition has been linked to increased rates of dislocation, impingement, pelvic osteolysis, cup migration, leg length discrepancy and polyethylene wear in patients undergoing total hip arthroplasty (THA).
OBJECTIVE
Compare the acetabular component positioning and the operative time in two consecutive short-stem cementless THA series without and with using an imageless navigation.
MATERIAL AND METHOD
The retrospective study consisted of 31 cases of short-stem cementless THA without navigation (NNAV) and 30 cases with navigation (NAV). CT scans were performed in all cases at two-month or later postoperatively. The abduction and anteversion angles measured on postoperative CT were compared between two groups using t-test. The percentage of cup placement (abduction, anteversion and combined) within the safe zone for each group was compared using Chi-square test at a 0.05 level of significance. The operative time was compared between two groups using t-test.
RESULTS
The mean abduction was 43.97 (range, 33-52, SD 4.44) in NNAV group and 41.37 (range, 37-45, SD 2.01) in NAV group. This difference was significant (p = 0.004). The mean anteversion was 22.58 (range, 2-39, SD 10.68) in NNAV group and 13.57 (range, 7-18, SD 3.28) in NAV group. This difference was significant (p < 0.001). According to the criteria of Lewinnek et al, 96.8% in NNAV group were placed within the safe zone for abduction, 51.6% for anteversion, and 48.4% for both abduction and anteversion. In NAV group, all 30 cups (100%) were placed within the safe zone for abduction, anteversion, and both. There were significant differences in the percentage of cup placement within the safe zone for anteversion (p < 0.001), for both abduction and anteversion (p < 0.001) but not significant for abduction (p = 0.32) between two groups. The mean operative time was 107.09 and 110.67 minutes for NNAV and NAV group respectively, this difference was not significant (p = 0.49).
CONCLUSION
The present study demonstrated a significant increase in the placement of acetabular cups within the safe zone using imageless navigation compared to freehand technique, especially at anteversion angle.