{"title":"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","authors":"","doi":"10.1016/j.artd.2024.101431","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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).</p></div><div><h3>Methods</h3><p>Between March 2017 and December 2021, 20 patients underwent preoperative two-dimensional (2D) planning (<em>2D group</em>), and 30 patients underwent 3D planning following the implementation of a new 3D planning software into clinical practice in September 2019 (<em>3D group</em>). Two observers, blinded to the groups, measured the <em>total screw length</em>, <em>screw penetration depth</em>, and cup position on available postoperative computed tomography examinations. For statistical comparisons, the mean measurement from the 2 observers was used.</p></div><div><h3>Results</h3><p>The median <em>total screw lengths</em> in the SPR were 16 mm in the <em>2D group</em> and 25 mm in the <em>3D group</em> (<em>P</em> = .004) and 40.5 mm compared with 50.5 mm in the ilium (<em>P</em> = .019). Median <em>screw penetration depths</em> in the SPR were 0 mm in the <em>2D group</em> and 1.25 mm in the <em>3D group</em> (<em>P</em> = .049).</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235234412400116X/pdfft?md5=6a14be5ac77c196a80993af8de27f6cc&pid=1-s2.0-S235234412400116X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Preoperative Three-Dimensional Planning Using Computed Tomography Improves Screw Placement in Patients Undergoing Acetabular Revision Surgery\",\"authors\":\"\",\"doi\":\"10.1016/j.artd.2024.101431\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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).</p></div><div><h3>Methods</h3><p>Between March 2017 and December 2021, 20 patients underwent preoperative two-dimensional (2D) planning (<em>2D group</em>), and 30 patients underwent 3D planning following the implementation of a new 3D planning software into clinical practice in September 2019 (<em>3D group</em>). Two observers, blinded to the groups, measured the <em>total screw length</em>, <em>screw penetration depth</em>, and cup position on available postoperative computed tomography examinations. For statistical comparisons, the mean measurement from the 2 observers was used.</p></div><div><h3>Results</h3><p>The median <em>total screw lengths</em> in the SPR were 16 mm in the <em>2D group</em> and 25 mm in the <em>3D group</em> (<em>P</em> = .004) and 40.5 mm compared with 50.5 mm in the ilium (<em>P</em> = .019). Median <em>screw penetration depths</em> in the SPR were 0 mm in the <em>2D group</em> and 1.25 mm in the <em>3D group</em> (<em>P</em> = .049).</p></div><div><h3>Conclusion</h3><p>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.</p></div>\",\"PeriodicalId\":37940,\"journal\":{\"name\":\"Arthroplasty Today\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S235234412400116X/pdfft?md5=6a14be5ac77c196a80993af8de27f6cc&pid=1-s2.0-S235234412400116X-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroplasty Today\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S235234412400116X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroplasty Today","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S235234412400116X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
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.
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.