Scott M LaValva, Geoffrey H Westrich, Robert C Marchand, Ajay C Lall, Benjamin G Domb, Jonathan M Vigdorchik, Seth A Jerabek
{"title":"多中心前瞻性评估机器人辅助全髋关节置换术对术中植入物定位虚拟运动范围的实用性。","authors":"Scott M LaValva, Geoffrey H Westrich, Robert C Marchand, Ajay C Lall, Benjamin G Domb, Jonathan M Vigdorchik, Seth A Jerabek","doi":"10.1177/11207000241254353","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The growing adoption of robotic-assistance during total hip arthroplasty (THA) has provided novel means through which a patient's anatomy and dynamic spinopelvic relationship can be incorporated into surgical planning. However, the impact of enhanced technologies on intraoperative decision-making and changes to component positioning has not yet been described.</p><p><strong>Methods: </strong>A multicentre, prospective study included 105 patients (52% women) patients who underwent robotic-assisted THA with the integration of software that incorporates a patient's pelvic tilt (PT) and virtual range-of-motion (VROM) for impingement modeling. The primary outcome of the study was the percentage of patients who underwent changes to the preoperative plan for cup position after incorporating the data from the software.</p><p><strong>Results: </strong>Utilising the intraoperative VROM information, the preoperative plan for cup position was changed from the default (40° inclination and 20° anteversion) in 82/105 (78%) cases. When stratifying by spinopelvic mobility, 64% were considered normal (change ⩾ 10° and ⩽30°), 27% were stiff (change < 10°), and 9% were hypermobile (change > 30°). For all cohorts, the majority of cases (78%) deviated from the 40° inclination and 20° version target. When evaluating the proportion of cases within the Lewinnek and Callanan safe zones based on spinopelvic mobility, 19% of cases within the normal group were planned outside of both zones compared to 39% of stiff cases and 10% of hypermobile cases.</p><p><strong>Conclusions: </strong>Utilising the latest version of robotic-assisted THA software, the preoperative plan for cup position was changed in the vast majority (78%) of patients, causing substantial deviations from traditional, generic cup targets.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A multicentre prospective assessment of the utility of robotic assisted total hip arthroplasty with virtual range of motion on intraoperative implant positioning.\",\"authors\":\"Scott M LaValva, Geoffrey H Westrich, Robert C Marchand, Ajay C Lall, Benjamin G Domb, Jonathan M Vigdorchik, Seth A Jerabek\",\"doi\":\"10.1177/11207000241254353\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The growing adoption of robotic-assistance during total hip arthroplasty (THA) has provided novel means through which a patient's anatomy and dynamic spinopelvic relationship can be incorporated into surgical planning. However, the impact of enhanced technologies on intraoperative decision-making and changes to component positioning has not yet been described.</p><p><strong>Methods: </strong>A multicentre, prospective study included 105 patients (52% women) patients who underwent robotic-assisted THA with the integration of software that incorporates a patient's pelvic tilt (PT) and virtual range-of-motion (VROM) for impingement modeling. The primary outcome of the study was the percentage of patients who underwent changes to the preoperative plan for cup position after incorporating the data from the software.</p><p><strong>Results: </strong>Utilising the intraoperative VROM information, the preoperative plan for cup position was changed from the default (40° inclination and 20° anteversion) in 82/105 (78%) cases. When stratifying by spinopelvic mobility, 64% were considered normal (change ⩾ 10° and ⩽30°), 27% were stiff (change < 10°), and 9% were hypermobile (change > 30°). For all cohorts, the majority of cases (78%) deviated from the 40° inclination and 20° version target. When evaluating the proportion of cases within the Lewinnek and Callanan safe zones based on spinopelvic mobility, 19% of cases within the normal group were planned outside of both zones compared to 39% of stiff cases and 10% of hypermobile cases.</p><p><strong>Conclusions: </strong>Utilising the latest version of robotic-assisted THA software, the preoperative plan for cup position was changed in the vast majority (78%) of patients, causing substantial deviations from traditional, generic cup targets.</p>\",\"PeriodicalId\":12911,\"journal\":{\"name\":\"HIP International\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"HIP International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/11207000241254353\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIP International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/11207000241254353","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/25 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
A multicentre prospective assessment of the utility of robotic assisted total hip arthroplasty with virtual range of motion on intraoperative implant positioning.
Background: The growing adoption of robotic-assistance during total hip arthroplasty (THA) has provided novel means through which a patient's anatomy and dynamic spinopelvic relationship can be incorporated into surgical planning. However, the impact of enhanced technologies on intraoperative decision-making and changes to component positioning has not yet been described.
Methods: A multicentre, prospective study included 105 patients (52% women) patients who underwent robotic-assisted THA with the integration of software that incorporates a patient's pelvic tilt (PT) and virtual range-of-motion (VROM) for impingement modeling. The primary outcome of the study was the percentage of patients who underwent changes to the preoperative plan for cup position after incorporating the data from the software.
Results: Utilising the intraoperative VROM information, the preoperative plan for cup position was changed from the default (40° inclination and 20° anteversion) in 82/105 (78%) cases. When stratifying by spinopelvic mobility, 64% were considered normal (change ⩾ 10° and ⩽30°), 27% were stiff (change < 10°), and 9% were hypermobile (change > 30°). For all cohorts, the majority of cases (78%) deviated from the 40° inclination and 20° version target. When evaluating the proportion of cases within the Lewinnek and Callanan safe zones based on spinopelvic mobility, 19% of cases within the normal group were planned outside of both zones compared to 39% of stiff cases and 10% of hypermobile cases.
Conclusions: Utilising the latest version of robotic-assisted THA software, the preoperative plan for cup position was changed in the vast majority (78%) of patients, causing substantial deviations from traditional, generic cup targets.
期刊介绍:
HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice.
The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit.
HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are:
• Biomaterials
• Biomechanics
• Conservative Hip Surgery
• Paediatrics
• Primary and Revision Hip Arthroplasty
• Traumatology