人工智能三维规划系统在全髋关节置换中的准确性及其影响因素  

Accuracy and influencing factor of artificial intelligence planning system in patients undergoing total hip arthroplasty

作　　者：张凯 郭卓涛 马桥桥 查国春 郭开今 Zhang Kai;Guo Zhuotao;Ma Qiaoqiao;Zha Guochun;Guo Kaijin(Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China;Department of Orthopedics,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China)

机构地区：[1]徐州医科大学,江苏省徐州市221000 [2]徐州医科大学附属医院骨科,江苏省徐州市221000

出　　处：《中国组织工程研究》2024年第12期1863-1868,共6页Chinese Journal of Tissue Engineering Research

基　　金：江苏省青年医学人才项目(QNRC2016800),项目负责人:查国春;江苏省卫生计生委面上项目(H2017081),项目负责人:查国春。

摘　　要：背景:人工智能三维规划系统能够自动建立三维模型并生成规划方案,但其预测假体型号的准确性尚未得到充分验证。目的:探讨人工智能三维规划系统在全髋关节置换前预测假体型号的准确性及对临床预后的影响,并进一步分析影响规划准确性的危险因素。方法:前瞻性收集2021年1月至2022年6月在徐州医科大学附属医院骨科接受单侧初次全髋关节置换患者的临床资料,随机分为人工智能组(n=80)和传统模板组(n=79)。对比两组术中使用假体与术前规划假体的匹配情况,记录术后随访Harris功能评分、双下肢不等长、脱位和假体松动等并发症的发生情况,采用单因素及多因素Logistic回归分析来探究人口统计学指标、术前诊断、Dorr分型对股骨柄规划准确性的影响。结果与结论:①人工智能组髋臼侧、股骨侧假体完全符合率分别为50%(40/80)、55%(44/80),传统模板组为34%(27/79)、37%(29/79),组间差异有显著性意义(P<0.05);②人工智能组在髋臼、股骨侧假体相差1个尺寸内的准确率分别91%(73/80)、86%(69/80),传统模板组为82%(65/79)、72%(58/79),差异仅在股骨侧有显著性意义(P<0.05);③两组术后随访期间均无脱位及假体松动的发生,人工智能组、传统模板组术后双下肢长度差值分别为(3.56±2.32)mm、(3.52±2.41)mm;末次随访时人工智能组与传统模板组Harris评分分别为(92.74±3.08)分、(91.81±3.52)分,上述指标两组比较差异均无显著性意义(P>0.05);④单因素分析结果显示,术前诊断为先天性髋关节发育不良、股骨头坏死以及Dorr B型、C型股骨对人工智能三维规划系统预测股骨假体准确率有显著影响(P<0.05);⑤多因素logistic回归分析显示,术前诊断为先天性髋关节发育不良(OR=18.233,95%CI:2.662-124.888)是影响人工智能三维规划系统预测股骨柄型号的独立危险因素;⑥提示人工智能三维规划系统预测假体型号较传统二�BACKGROUND:Artificial intelligence planning system can automatically establish a three-dimensional model and generate planning schemes,but its accuracy in predicting the prosthesis size has not been fully verified.OBJECTIVE:To investigate the accuracy of artificial intelligence planning system in predicting prosthesis size before total hip arthroplasty and its influence on clinical prognosis,and further analyze the risk factors affecting the accuracy of planning.METHODS:Clinical data of patients with unilateral initial total hip arthroplasty who were admitted to the Department of Orthopedics of Affiliated Hospital of Xuzhou Medical University from January 2021 to June 2022 were prospectively collected.The patients were randomly divided into the artificial intelligence planning system group(n=80)and the conventional template group(n=79).Intraoperative use of prostheses and preoperative planning of prosthesis matching were compared between the two groups.Postoperative follow-up Harris scores and the occurrence of complications such as leg length discrepancy,dislocation and prosthesis loosening were recorded in both groups.The effects of demographic indicators,preoperative diagnosis,and Dorr typing on the accuracy of femoral stem planning were explored using univariate and multivariate Logistic regression analyses.RESULTS AND CONCLUSION:(1)The prediction of the prosthesis size on the acetabular side and femoral side was 50%(40/80)and 55%(44/80)in the artificial intelligence planning system group,compared to 34%(27/79)and 37%(29/79)in the conventional template group,with statistically significant differences(P<0.05).(2)The artificial intelligence planning system group had an accuracy rate within one size difference for the acetabular and femoral side prostheses of 91%(73/80)and 86%(69/80),compared to 82%(65/79)and 72%(58/79)in the conventional template group,with differences statistically different only on the femoral side(P<0.05).(3)No dislocation or prosthesis loosening occurred in the two groups during postoperati

关 键 词：术前规划 人工智能 全髋关节置换 股骨近端髓腔形态 假体型号 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R687