全髋关节置换人工智能三维术前规划的临床应用
Application of artificial intelligence hip system for preoperative planning total hip arthroplasty
席立成 1方怀玺1
作者信息
- 1. 柳州市工人医院(广西医科大学第四附属医院)关节外科/骨肿瘤病区,广西柳州 545005
- 折叠
摘要
[目的]探讨人工智能THA术前规划系统(artificial intelligence hip,AIHIP)在全髋置换术(total hip arthroplasty,THA)应用的临床价值.[方法]选择2020年3月-2022年1月拟行单侧初次THA的112例患者,依据术前医患沟通结果,74例使用AIHIP系统(智能组),38例使用二维模板测量(常规组)进行术前规划.比较两组围手术期、随访及影像结果.[结果]智能组在手术时间[(78.4±29.6)min vs(89.1±34.3)min,P＜0.05]、髋臼假体符合率(98.6％vs 78.9％,P＜0.05)、股骨假体符合率(100.0％vs84.2％,P＜0.05)均显著优于常规组.两组切口长度、术中失血量、切口愈合等级、下地时间、住院时间的差异均无统计学意义(P＞0.05).所有患者均获随访12个月以上,智能组恢复完全负重活动时间显著早于常规组[(21.8±4.8)dvs(23.0±5.2)d,P＜0.05].随时间推移,两组患者髋关节Harris评分、伸屈ROM、VAS评分均显著改善(P＜0.05);术后1、6个月,智能组Harris评分和伸屈ROM、VAS评分均显著优于常规组(P＜0.05),但术后12个月时,两组上述指标的差异已无统计学意义(P＞0.05).影像方面,术后两组髋臼假体外翻角、前倾角、LLD、股骨柄大小合适程度及放置位置的差异均无统计学意义(P＞0.05).但是,智能组术后纵向髋旋转中心偏移[(1.0±0.0)mm vs(2.0±0.0)mm,P＜0.05]和横向髋旋转中心偏移[(2.0±0.0)mm vs(3.0±0.0)mm,P＜0.05]均显著小于常规组.[结论]AIHIP系统辅助下THA术前规划准确率高,能有效帮助重建髋关节旋转中心,缩短手术时间,早期恢复髋关节功能.
Abstract
[Objective]To evaluate the clinical value of artificial intelligence hip(AIHIP)system used in preoperative planning for total hip arthroplasty(THA).[Methods]A total of 112 patients who were undergoing unilateral primary THA from March 2020 to January 2022 were selected.According to preoperative doctor-patient communication,AIHIP system was used in 74 cases(intelligent group)and 2D tem-plate measurement was used in 38 cases(conventional group)for preoperative planning.The documents of perioperative period,follow-up and imaging were compared between the two groups.[Results]The intelligent group proved significantly superior to the conventional group in terms of operative time[(78.4±29.6)min vs(89.1±34.3)min,P＜0.05],accordance rate of acetabular component(98.6％vs 78.9％,P＜0.05)and accordance rate of femoral component(100.0％vs 84.2％,P＜0.05),despite of insignificant differences in incision length,intraoperative blood loss,incision healing grade,ambulation time,and hospital stay between the two groups(P＞0.05).All patients were followed up for more than 12 months,and the intelligent group resumed full weight-bearing activities significantly earlier than the conventional group[(21.8±4.8)days vs(23.0±5.2)days,P＜0.05].The Harris hip score,flexion-extension ROM and VAS scores significantly improved in both groups over time(P＜0.05).The intelligent group was significantly better than the conventional group in terms of Harris scores,extension ROM and VAS scores 1 and 6 months after operation(P＜0.05),but there was no statistically significant difference in abovementioned items between the two groups 12 months after surgery(P＞0.05).Radiographically,there were no statistically significant differences between the two groups in terms of acetabular abduction and anteversion,as well as leg length discrepancy(LLD),femoral stem size and its placement(P＞0.05).However,the intelligent group was significantly superior to the conventional group in deviation values of longitudinal hip center of rota-tion[(1.0±0.0)mm vs(2.0±0.0)mm,P＜0.05]and transverse hip center of rotation[(2.0±0.0)mm vs(3.0±0.0)mm,P＜0.05]postoperatively.[Conclusion]The AIHIP system has high accuracy in preoperative planning for THA,which can effectively help to reconstruct hip rotation center,shorten operation time and restore hip function in early stage.
关键词
全髋关节置换术/术前规划/人工智能/模板测量Key words
total hip arthroplasty/preoperative planning/artificial intelligence/template measurement引用本文复制引用
出版年
2024
NETL
NSTL
万方数据