使用计算机断层扫描进行术前三维规划可改善髋臼翻修手术患者的螺钉置放效果

IF 1.5 Q3 ORTHOPEDICS
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引用次数: 0

摘要

背景关节置换植入物的稳定固定对于实现非骨水泥植入物的骨结合至关重要。在髋臼翻修术中,为了获得足够的稳定性,通常需要在历史上所谓的 "安全 "区域以外的象限使用螺钉。本研究的主要目的是确定髋臼翻修手术的术前三维(3D)规划是否会影响螺钉长度,尤其是耻骨上隆突(SPR)的螺钉长度。方法在2017年3月至2021年12月期间,20名患者接受了术前二维(2D)规划(2D组),30名患者在2019年9月新的3D规划软件应用于临床实践后接受了3D规划(3D组)。两名观察者对各组进行了盲法操作,在现有的术后计算机断层扫描检查中测量了螺钉总长度、螺钉穿透深度和髋臼杯位置。结果 SPR 中位螺钉总长度二维组为 16 毫米,三维组为 25 毫米(P = .004),髂骨中位螺钉总长度为 40.5 毫米,三维组为 50.5 毫米(P = .019)。在 SPR 中,2D 组的中位螺钉穿透深度为 0 毫米,3D 组为 1.25 毫米(P = 0.049)。由于研究设计的原因,我们无法评估更长的螺钉是否能带来更好的固定效果。需要进一步研究来阐明这一问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preoperative Three-Dimensional Planning Using Computed Tomography Improves Screw Placement in Patients Undergoing Acetabular Revision Surgery

Background

Stable fixation of joint replacement implants is essential to achieve osseointegration in uncemented implants. In acetabular revisions, screws often need to be utilized in quadrants other than the historically so-called “safe” zones to attain sufficient stability. The primary aim of this study was to determine whether preoperative three-dimensional (3D) planning for acetabular revision surgery influences screw length, specifically in the superior pubic ramus (SPR).

Methods

Between March 2017 and December 2021, 20 patients underwent preoperative two-dimensional (2D) planning (2D group), and 30 patients underwent 3D planning following the implementation of a new 3D planning software into clinical practice in September 2019 (3D group). Two observers, blinded to the groups, measured the total screw length, screw penetration depth, and cup position on available postoperative computed tomography examinations. For statistical comparisons, the mean measurement from the 2 observers was used.

Results

The median total screw lengths in the SPR were 16 mm in the 2D group and 25 mm in the 3D group (P = .004) and 40.5 mm compared with 50.5 mm in the ilium (P = .019). Median screw penetration depths in the SPR were 0 mm in the 2D group and 1.25 mm in the 3D group (P = .049).

Conclusion

Longer screws were used in the SPR and ilium when preoperative 3D planning was conducted. Due to the study design, we were not able to evaluate whether longer screws lead to better fixation. Further studies are needed to elucidate this question.

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来源期刊
Arthroplasty Today
Arthroplasty Today Medicine-Surgery
CiteScore
2.90
自引率
0.00%
发文量
258
审稿时长
40 weeks
期刊介绍: Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.
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