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。

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-11-01 Epub Date: 2024-06-25 DOI:10.1177/11207000241254353
Scott M LaValva, Geoffrey H Westrich, Robert C Marchand, Ajay C Lall, Benjamin G Domb, Jonathan M Vigdorchik, Seth A Jerabek
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引用次数: 0

摘要

背景:全髋关节置换术(THA)中越来越多地采用机器人辅助,这为将患者的解剖结构和动态脊柱骨盆关系纳入手术规划提供了新的手段。然而,增强型技术对术中决策和组件定位变化的影响尚未得到描述:一项多中心、前瞻性研究纳入了 105 名患者(52% 为女性),这些患者接受了机器人辅助 THA 手术,手术中使用了结合患者骨盆倾斜(PT)和虚拟运动范围(VROM)的软件进行撞击建模。研究的主要结果是,在纳入软件数据后,对术前计划的髋臼杯位置进行更改的患者比例:结果:利用术中VROM信息,82/105(78%)例患者术前改变了髋臼杯位置计划(40°倾斜和20°前屈)。根据脊柱骨盆活动度进行分层时,64%的病例被认为是正常的(变化⩾10°和⩽30°),27%的病例是僵硬的(变化<10°),9%的病例是过度活动的(变化>30°)。在所有组群中,大多数病例(78%)偏离了 40° 倾角和 20° 曲度的目标。在根据脊柱骨盆活动度评估Lewinnek安全区和Callanan安全区的病例比例时,正常组中有19%的病例超出了这两个安全区,而僵硬病例和过度活动病例分别为39%和10%:利用最新版本的机器人辅助 THA 软件,绝大多数(78%)患者的髋臼杯位置术前计划都发生了改变,导致与传统的通用髋臼杯目标出现了很大偏差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
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
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