Computer Navigation-Assisted Osteochondroplasty May Improve Accuracy of Resection Planning With Limited Outcome Differences Compared With Freehand Hip Arthroscopic Technique in Patients With Femoroacetabular Impingement Syndrome.
{"title":"Computer Navigation-Assisted Osteochondroplasty May Improve Accuracy of Resection Planning With Limited Outcome Differences Compared With Freehand Hip Arthroscopic Technique in Patients With Femoroacetabular Impingement Syndrome.","authors":"Masayoshi Saito, Shota Higashihira, Yohei Yukizawa, Hyonmin Choe, Hiroyuki Ike, Ken Kumagai, Yutaka Inaba, Naomi Kobayashi","doi":"10.1016/j.arthro.2025.07.048","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the achievement of the preoperative plan and clinical outcomes in patients with cam- or combined-type femoroacetabular impingement syndrome undergoing computer navigation-assisted arthroscopic osteochondroplasty compared with freehand techniques.</p><p><strong>Methods: </strong>This retrospective study included patients treated between 2020 and 2024 who met the following criteria: (1) primary hip arthroscopic surgery for cam- or combined-type femoroacetabular impingement syndrome, (2) availability of pre- and postoperative computed tomography imaging, and (3) minimum 12-month follow-up. Patients were divided into a navigation-assisted group and a freehand group. In the navigation group, a computed tomography-based system was used, enabling real-time tracking of the abrader burr during resection. Achievement of the preoperative plan was assessed by comparing postoperative 3-dimensional range of motion simulations to preoperative targets at 90°, 70°, and 45° of hip flexion. Clinical outcomes included the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS).</p><p><strong>Results: </strong>Fifty-five hips were included (25 in the navigation-assisted group and 30 in the freehand group). Mean follow-up was 14.7 ± 4.4 months (range, 12-25 months) in the navigation group and 31.3 ± 11.2 months (range, 12-58 months) in the freehand group. The navigation group had greater achievement rates of the preoperative range of motion plan at 90° (92.0% vs 46.7%, P < .001) and 70° (80.0% vs 50.0%, P = .027). At 1 year, NAHS was greater in the navigation group (88.6 ± 9.2 vs 79.8 ± 18.9, P = .037), with more patients achieving the minimal clinically important difference (76.0% vs 46.7%, P = .032). There were no significant differences in mHHS, revision arthroscopy, or conversion to total hip arthroplasty.</p><p><strong>Conclusions: </strong>Computer navigation-assisted osteochondroplasty may improve the accuracy of cam resection and contribute to better short-term outcomes such as the NAHS at 1 year. However, clinical benefits over freehand technique were limited in other measures such as mHHS, revision, or conversion rates.</p><p><strong>Level of evidence: </strong>Level Ⅲ, retrospective comparative study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2025.07.048","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To evaluate the achievement of the preoperative plan and clinical outcomes in patients with cam- or combined-type femoroacetabular impingement syndrome undergoing computer navigation-assisted arthroscopic osteochondroplasty compared with freehand techniques.
Methods: This retrospective study included patients treated between 2020 and 2024 who met the following criteria: (1) primary hip arthroscopic surgery for cam- or combined-type femoroacetabular impingement syndrome, (2) availability of pre- and postoperative computed tomography imaging, and (3) minimum 12-month follow-up. Patients were divided into a navigation-assisted group and a freehand group. In the navigation group, a computed tomography-based system was used, enabling real-time tracking of the abrader burr during resection. Achievement of the preoperative plan was assessed by comparing postoperative 3-dimensional range of motion simulations to preoperative targets at 90°, 70°, and 45° of hip flexion. Clinical outcomes included the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS).
Results: Fifty-five hips were included (25 in the navigation-assisted group and 30 in the freehand group). Mean follow-up was 14.7 ± 4.4 months (range, 12-25 months) in the navigation group and 31.3 ± 11.2 months (range, 12-58 months) in the freehand group. The navigation group had greater achievement rates of the preoperative range of motion plan at 90° (92.0% vs 46.7%, P < .001) and 70° (80.0% vs 50.0%, P = .027). At 1 year, NAHS was greater in the navigation group (88.6 ± 9.2 vs 79.8 ± 18.9, P = .037), with more patients achieving the minimal clinically important difference (76.0% vs 46.7%, P = .032). There were no significant differences in mHHS, revision arthroscopy, or conversion to total hip arthroplasty.
Conclusions: Computer navigation-assisted osteochondroplasty may improve the accuracy of cam resection and contribute to better short-term outcomes such as the NAHS at 1 year. However, clinical benefits over freehand technique were limited in other measures such as mHHS, revision, or conversion rates.
Level of evidence: Level Ⅲ, retrospective comparative study.
目的：评价计算机导航辅助关节镜下单股或混合型股髋臼撞击综合征（FAIS）患者行计算机导航辅助关节镜下骨软骨成形术与徒手成形术的术前计划和临床结果。方法：本回顾性研究纳入了2020年至2024年期间接受治疗的患者，符合以下标准：(1)髋关节镜手术治疗凸轮或联合型FAIS，(2)术前和术后CT成像的可用性，(3)至少12个月的随访。患者分为导航辅助组和徒手组。导航组使用基于ct的系统，可以在切除过程中实时跟踪磨刀毛刺。通过比较术后3D ROM模拟与术前髋关节屈曲90°、70°和45°的目标来评估术前计划的实现情况。临床结果包括改良Harris髋关节评分（mHHS）和非关节炎髋关节评分（NAHS）。结果：共纳入55个髋部（导航辅助组25个，徒手组30个）。导航组平均随访14.7±4.4个月（范围：12-25个月），徒手组平均随访31.3±11.2个月（范围：12-58个月）。导航组术前ROM计划在90°（92.0% vs 47.0%, P < 0.001）和70°（80.0% vs 50.0%, P = 0.027）的成活率较高。1年时，导航组NAHS较高（88.6±9.2 vs 79.8±18.9,P = 0.037），达到MCID的患者较多（76.0% vs 46.7%, P = 0.032）。在mHHS、关节镜翻修或全髋关节置换术方面没有显著差异。结论：计算机导航辅助的骨软骨成形术可以提高凸轮切除术的准确性，并有助于改善短期预后，如1年的NAHS。然而，与徒手技术相比，临床益处在其他指标（如mHHS、修正或转换率）上受到限制。证据水平：Ⅲ，回顾性比较研究。
期刊介绍：
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
