数字化术前计划在人工髋关节翻修髋臼重建术中的初步应用评估

目的探讨数字化术前计划在提高全髋关节翻修中髋臼旋转中心精确重建中的应用价值。方法对人工髋关节翻修髋臼旋转中心重建病例进行数字化术前计划。患者男3例,女4例,年龄平均72.1岁（56～83岁）。以非手术正常侧髋臼旋转中心为标准,以双侧骨盆泪滴下缘连线及骨盆中垂线为参照基准线设定翻修侧髋关节旋转中心水平及垂直位置距离,制定重建方案。比较计划与手术实际间髋臼中心的吻合程度。结果术前做计划与术后真实情况的差值间无明显差异（t水平=0.416,P水平=0.692;t垂直=0.399,P垂直=0.704）。结论数字化术前计划可为术中内植物及骨重建的组合选择提供更多有用信息,使因骨缺损所致移位的髋臼旋转中心恢复解剖位置,有利于患肢的长度及偏心距的恢复。

Evaluation of digital pre-operative plan for acetabular rotation center reconstruction in revision of total hip replacement

Objective To evaluate the role of digital pre-operative plan in improving the accuracy of acetabular rotation center reconstruction during the revision of total hip replacement.Methods Digital pre-operative plan was carried out in the patients who received reconstruction of the acetabular rotation center during the revision total hip.Among the selected seven patients,three were males and four were females,age ranging from 56 to 83 years,72.1 years in average.The horizontal and vertical distances of the acetabular rotation center of the revision site were set;the reconstruction protocol was determined,using the normal acetabular rotation center of contralateral hip as a reference,and the horizontal line through points at the most inferior aspect of the acetabular teardrop of bilateral pelvis was used as the baseline.The consistency of acetabular rotation center of digital pre-operative plan and the actual one were compared.Results There was no significant difference between the pre-operative plan and the postoperative one(thorizontal=0.416,Phorizontal=0.692;tvertical=0.399,Pvertical=0.704).Conclusions Digital preoperative plan can provide useful information for the choice of implants and bone reconstruction during surgery to achieve anatomical reconstruction of the acetabular rotation center and will be beneficial for restoring the leg length and offset of the operative side.