Artificial intelligence total hip arthroplasty preoperative planning verified in cadavers
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NSTL
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[目的]验证"肩对肩"解剖标记定位法在大体标本全髋关节置换(total hip arthroplasty,TH A)中恢复下肢长度的作用.[方法]在4具尸体行闭孔外肌肌腱止点的下为截骨标志的"肩对肩"THA,测量术后骨盆正位片下肢长度、尖肩距、截骨距、股骨头旋转中心(center of rotation,COR)纵向及水平偏移度、髋臼外展角及前倾角,并与人工智能辅助规划系统(AI-HIP)进行验证.[结果]4具尸体术后均达到双下肢等长.术后影像学与AIHIP规划的尖肩距、截骨距、股骨头旋转中心纵向偏移度及旋转中心水平偏移度比较差异均无统计学意义(P＞0.05);术后影像学测量的髋臼外展角[(32.5±3.1)°vs(41.3±2.5)°,P=0.005]显著小于AIHIP规划的髋臼外展角,术后影像学测量的髋臼前倾角[(25.3±9.4)° vs(18.8±2.5)°,P=0.030]显著大于AIHIP规划的髋臼前倾角.术中测量的尖肩距显著大于术后影像测量[(26.3±2.6)mm vs(15.5±1.5)mm,P＜0.001]和术前AIHIP规划[(26.3±2.6)mm vs(17.0±2.2)mm,P＜0.001].[结论]尸体手术对AIHIP的验证表明,股骨侧"肩对肩"解剖标记定位法能够保证股骨侧假体准确置入合适位置,有效恢复下肢长度,尽管不同时间点测量的部分参数有差异.
[Objective]To verify the effect of"shoulder-to-shoulder"anatomical marker localization in restoring lower limb length dur-ing total hip arthroplasty(THA).[Methods]"Shoulder-to-shoulder"THA was performed in 4 cadavers based on insertion obturator exter-nus as the"shoulder"of the femur for osteotomy.The length of lower limb,tip-shoulder distance,osteotomy distance,longitudinal and horizontal deviation of center of rotation(COR)of femoral head,acetabular abduction angle and acetabular anteversion angle were mea-sured,and verified with the artificial intelligence hip(AIHIP).[Results]All the 4 cadavers got equal length of bilateral lower limbs after op-eration.There were no statistically significant differences in tip-shoulder distance,osteotomy distance,longitudinal and horizontal devia-tions of femoral head COR between the postoperative imaging measurement and the preoperative AIHIP planning(P＞0.05).However,the acetabular abduction angle measured by postoperative image was significantly lower than that planned by AIHIP[(32.5±3.1)° vs(41.3±2.5)°,P=0.005],while the acetabular anteversion measured postoperatively were significantly greater than that planned by AIHIP[(25.3±9.4)° vs(18.8±2.5)°,P=0.030].In addition,The tip-shoulder distance measured intraoperatively was significantly greater than that mea-sured by postoperative imaging[(26.3±2.6)mm vs(15.5±1.5)mm,P＜0.001],and preoperative AIHIP planning[(26.3±2.6)mm vs(17.0±2.2)mm,P＜0.001].[Conclusion]The validation of AIHIP after cadaveric surgery shows that the"shoulder-to-shoulder"as anatomic mark-er for femoral stem placement does ensure the accurate placement and effectively restore the lower limb length,although some parameters measured at different time points are different.
total hip arthroplastycadaveric surgeryartificial intelligence planninganatomical markersmeasurement
NETL
NSTL
万方数据
