小切口人工全髋关节置换术中使用计算机导航对于提高髋臼置入精度的临床观察  

Accuracy of acetabular component position in mini-incision surgery of total hip arthroplasty with and without navigation

作　　者：姚辉[1] 卢华定[1] 侯刚[1] 赵慧清[1] 吕璐璐[1] 

机构地区：[1]中山大学附属第三医院岭南医院骨科,广州510100

出　　处：《中国矫形外科杂志》2013年第20期2035-2039,共5页Orthopedic Journal of China

摘　　要：[目的]探讨在小切口人工全髋关节置换术中使用计算机导航对于提高髋臼置入精确度的意义。[方法]2008年7月～2009年10月对56例髋关节病变患者(均为单侧髋)采用小切口人工全髋关节置换术,其中使用计算机导航辅助手术组26例26髋,男14例,女12例,平均年龄(65±14.3)岁,未使用计算机的传统小切口手术组30例30髋,男19例,女11例,平均年龄(67±12.9)岁。比较两组病例切口长度、手术时间、术中出血量、术后引流量、术后Harris评分、并发症及髋臼假体角度,分析小切口人工全髋关节置换术中使用计算机导航的临床意义。[结果]两组在手术时间及术后Harris评分方面无统计学差别。手术切口导航组(4.9±0.65)cm,明显小于传统组(8.0±0.85)cm,差异具有统计学意义(P<0.05)。导航组术中失血量为(373.9±124.55)ml,术后引流量(488.9±225.36)ml,明显小于传统组术中失血(513.7±121.92)ml及术后引流(628.7±193.96)ml,差异均具有统计学意义(P<0.05)。导航组术后所测前倾角为(15.5±2.2)°,外展角为(41.0±1.6),传统组分别为(19.4±2.5)°和(45.5±2.0)°,差异均具有统计学意义(P<0.05),且导航组术后所测数值更集中于术前所设定的理想值(术前设定理想的前倾角为15°,外展角40°)。导航组术后1例发生大转子骨折无移位,传统组术后1例发生假体下骨折,其余病例均无并发症。[结论]小切口全髋关节置换术中,采用计算机导航可进一步减少手术创伤并提高髋臼的置入精度。[ Objective] To affirm whether the accuracy of acetabular component position will be improved by navigation. [ Method] From July 2008 to October 2009,56 patients with unilateral hip joint disease were performed with mini - in cision to-tal hip arthroplasty. Out of them,26 patients（ 14 men and 12 women） with the mean age （65 ± 14.3） years were operated with the aide of computer navigation system. The other 30 patients （19 men and 11 women） with the mean age （67 ± 12.9 ） years were performed traditionally without navigation. Operation time, blood loss, incision length, acetabular component orientation, postoperative Harris score and operation related complications were analyzed. [ Result] There were no significant differences in operation time and postoperative Harris score between the two groups. The mean incision length of the navigation group was （4. 9 ~ 0.65 ） cm and the corresponding length in the traditional group was （ 8.0 ± 0.85 ） cm which was significantly longer （ P 〈 0. 05） than in the navigation group. The intra-operative and postoperative blood loss in the traditional group was （513.7 ± 121. 92） ml and （628.7 ± 193.96） ml, which were much more （ P 〈 0.05 ） than in the navigation group with the mean intra - operative blood loss（373.9 ± 124.55 ）ml and postoperative blood loss（488.9 ± 225.36）ml. The mean anteversion and inclinasion angles in the navigation group were （ 15.5 ± 2.2 ）°, （41.0 ± 1.6 ） ° and （ 19.4 ± 2.5 ） °, （ 45.5 ± 2.0 ） ° for the traditional group, and the difference was statistically significant. The navigated angles were more accurate and more satisfactory. A greater trochanter fracture without displacement in the navigation group and a fracture below the prosthesis in the traditional group were observed postoperatively, without other complications encountered. [ Conclusion ] Using a computer navigation system in mini - incision total hip arthroplasty can ulteriorly reduce the operation trauma and improve

关 键 词：小切口 关节成形术 置换 髋臼 计算机辅助 

分 类 号：R687.4[医药卫生—骨科学]