初级全髋关节置换术中术中确定合适髋臼杯尺寸的技术说明

P. Karampinas, J. Vlamis, Athanasios S. Galanis, Michail Vavourakis, Anastasia Krexi, E. Sakellariou, Christos Patilas, Spiros Pneumaticos
{"title":"初级全髋关节置换术中术中确定合适髋臼杯尺寸的技术说明","authors":"P. Karampinas, J. Vlamis, Athanasios S. Galanis, Michail Vavourakis, Anastasia Krexi, E. Sakellariou, Christos Patilas, Spiros Pneumaticos","doi":"10.5662/wjm.v14.i1.90930","DOIUrl":null,"url":null,"abstract":"BACKGROUND\n Selecting the optimal size of components is crucial when performing a primary total hip arthroplasty. Implanting the accurate size of the acetabular component can occasionally be exacting, chiefly for surgeons with little experience, whilst the complications of imprecise acetabular sizing or over-reaming can be potentially devastating.\n AIM\n To assist clinicians intraoperatively with a simple and repeatable tip in elucidating the ambivalence when determining the proper acetabular component size is not straightforwardly achieved, specifically when surgeons are inexperienced or preoperative templating is unavailable.\n METHODS\n This method was employed in 263 operations in our department from June 2021 to December 2022. All operations were performed by the same team of joint reconstruction surgeons, employing a typical posterior hip approach technique. The types of acetabular shells implanted were: The Dynasty® acetabular cup system (MicroPort Orthopedics, Shanghai, China) and the R3® acetabular system (Smith & Nephew, Watford, United Kingdom), which both feature cementless press-fit design.\n RESULTS\n The mean value of all cases was calculated and collated with each other. We distinguished as oversized an implanted acetabular shell when its size was > 2 mm larger than the size of the acetabular size indicator reamer (ASIR) or when the implanted shell was larger than 4 mm compared to the preoperative planned cup. The median size of the implanted acetabular shell was 52 (48–54) mm, while the median size of the preoperatively planned cup was 50 (48–56) mm, and the median size of the ASIR was 52 (50–54) mm. The correlation coefficient between ASIR size and implanted acetabular component size exhibited a high positive correlation with r = 0.719 (P < 0.001). Contrariwise, intraoperative ASIR measurements precisely predicted the implanted cups’ size or differed by only one size (2 mm) in 245 cases.\n CONCLUSION\n In our study, we demonstrated that the size of the first acetabular reamer not entering freely in the acetabular rim corroborates the final acetabular component size to implant. This was also corresponding in the majority of the cases with conventional preoperative templating. It can be featured as a valid tool for avoiding the potentially pernicious complications of acetabular cup over-reaming and over-sizing in primary total hip arthroplasty. It is a simple and reproducible technical note useful for confirming the predicted acetabular cup size preoperatively; thus, its application could be considered routinely, even in cases where preoperative templating is unavailable.","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Technical note for intraoperative determination of proper acetabular cup size in primary total hip arthroplasty\",\"authors\":\"P. Karampinas, J. Vlamis, Athanasios S. Galanis, Michail Vavourakis, Anastasia Krexi, E. Sakellariou, Christos Patilas, Spiros Pneumaticos\",\"doi\":\"10.5662/wjm.v14.i1.90930\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND\\n Selecting the optimal size of components is crucial when performing a primary total hip arthroplasty. Implanting the accurate size of the acetabular component can occasionally be exacting, chiefly for surgeons with little experience, whilst the complications of imprecise acetabular sizing or over-reaming can be potentially devastating.\\n AIM\\n To assist clinicians intraoperatively with a simple and repeatable tip in elucidating the ambivalence when determining the proper acetabular component size is not straightforwardly achieved, specifically when surgeons are inexperienced or preoperative templating is unavailable.\\n METHODS\\n This method was employed in 263 operations in our department from June 2021 to December 2022. All operations were performed by the same team of joint reconstruction surgeons, employing a typical posterior hip approach technique. The types of acetabular shells implanted were: The Dynasty® acetabular cup system (MicroPort Orthopedics, Shanghai, China) and the R3® acetabular system (Smith & Nephew, Watford, United Kingdom), which both feature cementless press-fit design.\\n RESULTS\\n The mean value of all cases was calculated and collated with each other. We distinguished as oversized an implanted acetabular shell when its size was > 2 mm larger than the size of the acetabular size indicator reamer (ASIR) or when the implanted shell was larger than 4 mm compared to the preoperative planned cup. The median size of the implanted acetabular shell was 52 (48–54) mm, while the median size of the preoperatively planned cup was 50 (48–56) mm, and the median size of the ASIR was 52 (50–54) mm. The correlation coefficient between ASIR size and implanted acetabular component size exhibited a high positive correlation with r = 0.719 (P < 0.001). Contrariwise, intraoperative ASIR measurements precisely predicted the implanted cups’ size or differed by only one size (2 mm) in 245 cases.\\n CONCLUSION\\n In our study, we demonstrated that the size of the first acetabular reamer not entering freely in the acetabular rim corroborates the final acetabular component size to implant. This was also corresponding in the majority of the cases with conventional preoperative templating. It can be featured as a valid tool for avoiding the potentially pernicious complications of acetabular cup over-reaming and over-sizing in primary total hip arthroplasty. It is a simple and reproducible technical note useful for confirming the predicted acetabular cup size preoperatively; thus, its application could be considered routinely, even in cases where preoperative templating is unavailable.\",\"PeriodicalId\":94271,\"journal\":{\"name\":\"World journal of methodology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-03-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World journal of methodology\",\"FirstCategoryId\":\"0\",\"ListUrlMain\":\"https://doi.org/10.5662/wjm.v14.i1.90930\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World journal of methodology","FirstCategoryId":"0","ListUrlMain":"https://doi.org/10.5662/wjm.v14.i1.90930","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:在进行初级全髋关节置换术时,选择最佳尺寸的组件至关重要。植入准确尺寸的髋臼组件有时会非常困难,主要是对经验不足的外科医生而言,而髋臼尺寸不精确或过大的并发症可能会造成严重后果。目的 通过一种简单、可重复的提示,帮助临床医生在术中阐明在确定合适的髋臼组件尺寸时无法直接实现的矛盾心理,特别是当外科医生缺乏经验或术前没有模板时。方法 从 2021 年 6 月到 2022 年 12 月,我们科室在 263 例手术中采用了这种方法。所有手术均由同一组关节重建外科医生采用典型的髋关节后入路技术完成。植入的髋臼壳类型有Dynasty®髋臼杯系统(MicroPort Orthopedics,中国上海)和R3®髋臼系统(Smith & Nephew,英国沃特福德),均采用无骨水泥压入式设计。结果 我们计算了所有病例的平均值,并进行了核对。当植入的髋臼壳的尺寸比髋臼尺寸指示器(ASIR)的尺寸大2毫米以上,或植入的髋臼壳比术前计划的髋臼杯大4毫米以上时,我们将其区分为超大髋臼壳。植入的髋臼外壳的中位尺寸为 52(48-54)毫米,而术前计划的髋臼杯的中位尺寸为 50(48-56)毫米,ASIR 的中位尺寸为 52(50-54)毫米。ASIR 尺寸与植入髋臼组件尺寸之间的相关系数为 r = 0.719(P < 0.001),呈高度正相关。相反,在 245 个病例中,术中 ASIR 测量值可精确预测植入髋臼杯的尺寸,或仅相差一个尺寸(2 毫米)。结论 在我们的研究中,我们证明了第一个不能自由进入髋臼边缘的髋臼铰刀的尺寸与最终植入的髋臼组件尺寸相吻合。在大多数病例中,这与传统的术前模板也是一致的。它可以作为一种有效的工具,避免在初级全髋关节置换术中出现髋臼杯过大和过小的潜在并发症。它是一种简单且可重复的技术说明,可用于术前确认预测的髋臼杯大小;因此,即使在没有术前模板的情况下,也可考虑将其作为常规应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Technical note for intraoperative determination of proper acetabular cup size in primary total hip arthroplasty
BACKGROUND Selecting the optimal size of components is crucial when performing a primary total hip arthroplasty. Implanting the accurate size of the acetabular component can occasionally be exacting, chiefly for surgeons with little experience, whilst the complications of imprecise acetabular sizing or over-reaming can be potentially devastating. AIM To assist clinicians intraoperatively with a simple and repeatable tip in elucidating the ambivalence when determining the proper acetabular component size is not straightforwardly achieved, specifically when surgeons are inexperienced or preoperative templating is unavailable. METHODS This method was employed in 263 operations in our department from June 2021 to December 2022. All operations were performed by the same team of joint reconstruction surgeons, employing a typical posterior hip approach technique. The types of acetabular shells implanted were: The Dynasty® acetabular cup system (MicroPort Orthopedics, Shanghai, China) and the R3® acetabular system (Smith & Nephew, Watford, United Kingdom), which both feature cementless press-fit design. RESULTS The mean value of all cases was calculated and collated with each other. We distinguished as oversized an implanted acetabular shell when its size was > 2 mm larger than the size of the acetabular size indicator reamer (ASIR) or when the implanted shell was larger than 4 mm compared to the preoperative planned cup. The median size of the implanted acetabular shell was 52 (48–54) mm, while the median size of the preoperatively planned cup was 50 (48–56) mm, and the median size of the ASIR was 52 (50–54) mm. The correlation coefficient between ASIR size and implanted acetabular component size exhibited a high positive correlation with r = 0.719 (P < 0.001). Contrariwise, intraoperative ASIR measurements precisely predicted the implanted cups’ size or differed by only one size (2 mm) in 245 cases. CONCLUSION In our study, we demonstrated that the size of the first acetabular reamer not entering freely in the acetabular rim corroborates the final acetabular component size to implant. This was also corresponding in the majority of the cases with conventional preoperative templating. It can be featured as a valid tool for avoiding the potentially pernicious complications of acetabular cup over-reaming and over-sizing in primary total hip arthroplasty. It is a simple and reproducible technical note useful for confirming the predicted acetabular cup size preoperatively; thus, its application could be considered routinely, even in cases where preoperative templating is unavailable.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信