在全髋关节置换术中,比较三种使用逆治疗概率加权法的导航模型的髋臼杯置放准确性

Shotaro Tachibana, Shinya Hayashi, Yuichi Kuroda, Tomoyuki Kamenaga, Masanori Tsubosaka, Kensuke Wada, Yoshihito Suda, Yuma Onoi, Kemmei Ikuta, Kensuke Anjiki, Naoki Nakano, Tomoyuki Matsumoto, Ryosuke Kuroda
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引用次数: 0

摘要

目的比较三种便携式导航系统在全髋关节置换术中髋臼杯放置的准确性。进一步探讨了影响精度的因素。方法对101例采用加速度计导航、3D微型光学导航和增强现实(AR)导航的THA患者进行分析。术后杯子放置角度采用三维模板测量。根据年龄、性别、身体质量指数(BMI)和目标放置角度计算倾向得分。采用治疗权重匹配逆概率对混杂因素进行校正后,采用单因素方差分析分析术中、术后倾斜角和前倾角的绝对差异(p <;0.05)。使用t检验和Fisher精确检验比较异常值(倾斜或前倾的绝对差值>;5°)和非异常值的背景。此外,进行逻辑回归分析以计算背景异常值的优势比。结果加速度计导航、3D微型光学导航和ar导航术中、术后倾斜角度绝对差值分别为2.8°、3.0°和2.9°,差异无统计学意义。加速度计导航组前倾角平均差异为2.2°,3D微型光学导航组前倾角平均差异为2.7°,ar导航组前倾角平均差异为2.2°,差异不显著。异常组BMI显著增高(p = 0.03), logistic回归分析结果显示比值比为1.2 (p = 0.02)。结论在校正混杂因素后,三种导航系统的杯子放置精度无显著差异。高BMI可能会影响准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of cup placement accuracy using the navigation in total hip arthroplasty between three models using inverse probability of treatment weighting

Purpose

This study compared the accuracy of acetabular cup placement between three portable navigation systems during total hip arthroplasty (THA). Furthermore, factors affecting accuracy were investigated.

Methods

A total of 101 patients who underwent THA using accelerometer-based navigation, 3D mini-optical navigation, or augmented reality (AR)-based navigation were analyzed. Post-operative cup placement angles were measured using three-dimensional templates. Propensity scores were calculated based on age, sex, body mass index (BMI), and target placement angle. After adjusting for confounding factors using inverse probability of treatment weighting matching, absolute differences in post-operative and intra-operative inclination and anteversion angles were analyzed using one-way analysis of variance (p ​< ​0.05). The backgrounds of outliers (an absolute difference in inclination or anteversion >5°) and non-outliers were compared using t-test and Fisher's exact test. Additionally, logistic regression analysis was performed to calculate the odds ratios of background outliers.

Results

The absolute differences in post-operative and intra-operative inclination angles were 2.8°, 3.0°, and 2.9° for accelerometer-based navigation, 3D mini-optical navigation, and AR-based navigation, respectively, with no significant differences. The mean differences in anteversion angles among the groups were 2.2° for accelerometer-based navigation, 2.7° for 3D mini-optical navigation, and 2.2° for AR-based navigation, with no significant differences. BMI was significantly higher in the outlier group (p ​= ​0.03), and logistic regression analysis results showed an odds ratio of 1.2 (p ​= ​0.02).

Conclusions

This study demonstrated no significant differences in cup placement accuracy among the three navigation systems after adjusting for confounding factors. High BMI may have affected accuracy.
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