全膝关节置换术中基于RSA的股骨假体计算机断层扫描精度：一项猪尸体研究

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-07 DOI:10.1016/j.clinbiomech.2025.106456

Frank-David Øhrn , Lars H.W. Engseth , Are H. Pripp , Anselm Schulz , Stephan M.H. Röhrl

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引用次数: 0

摘要

放射立体分析是评估骨科植入物迁移的金标准。新的基于ct的放射立体分析对胫骨植入物的评估具有很高的精度。我们分析了不同剂量水平下膝关节置换术中股骨假体ct放射立体分析的精度，并将其与先前发表的胫骨假体放射立体分析的结果和现有文献进行了比较。方法对猪尸体膝关节进行全膝关节置换术。在随后的7次CT扫描中，我们分析了21个不同有效剂量（标准剂量和低剂量）的样品中基于CT的放射立体分析方法的精度，并将其与放射立体分析文献进行了比较。发现基于sct的放射立体分析股骨和胫骨部件的最大总点运动显示（平均值，95%可信区间）0.18 mm(0.13至0.22),P <；0.001. 对于股骨植入物（平均值，95%置信区间，标准差），我们发现标准和低剂量方案的精度分别为0.25 mm（0.21-0.29, 0.1）和0.29 (0.25 - 0.32,0.08)mm。胫骨与股骨、标准剂量与低剂量股骨的变异性比（95%可信区间）分别为18.3（7.4-45.1）和0.7 (0.3-1.7)，p值分别为0.001和0.40。基于ct的全膝关节置换术中股骨植入物的放射立体分析是可行的，与基于ct的猪尸体胫骨植入物的放射立体分析相比，其精度较低，但仍然可以接受。然而，临床研究的证实是有必要的。

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Precision of computer tomography based RSA on femoral implants in total knee arthroplasty: A porcine cadaver study

Background

Radiostereometric analysis is the gold standard for assessing migration of orthopaedic implants. The novel CT-based radiostereometric analysis yields high precision of evaluation of tibial implants. We analyzed the precision of CT-based radiostereometric analysis on femoral implants in knee arthroplasty at different dose levels, and compared it to previously published results on tibial implants and the available literature on precision of radiostereometric analysis.

Methods

We performed a total knee arthroplasty on a porcine cadaver knee. In the subsequent 7 CT scans, we analyzed the precision of the CT-based radiostereometric analysis method in 21 samples at two different effective doses (standard and low dose), and compared this to literature on radiostereometric analysis.

Findings

CT-based radiostereometric analysis of maximum total point motion of femoral and tibial components showed a precision difference of (mean, 95 % confidence interval) 0.18 mm (0.13 to 0.22), P < 0.001. For femoral implants (mean, 95 % confidence interval, standard deviation) we found precisions of 0.25 mm (0.21–0.29, 0.1) and 0.29 (0.25–0.32, 0.08) mm for the standard and low dose protocols respectively. Variability ratios of tibia versus femur and standard versus low dose femur (95 % confidence interval) were 18.3 (7.4–45.1) and 0.7 (0.3–1.7) with respective P-values of <0.001 and 0.40.

Interpretation

CT-based radiostereometric analysis on femoral implants in total knee arthroplasty is feasible and has a lower, yet still acceptable, precision compared to CT-based radiostereometric analysis on tibial implants in a porcine cadaver. However, confirmation in clinical studies is warranted.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.