摘要
背景:传统X射线胶片术前规划常常不准确,会导致一些术中和术后并发症,增加了手术时间和术中出血量,一定程度影响了全髋关节置换的手术效果。目的:研究人工智能(AI)术前规划在全髋关节置换术中的准确性和应用效果。方法:选取患侧初次行全髋关节置换的患者60例,其中30例应用人工智能(AI)三维术前规划为试验组、30例应用传统X射线胶片二维术前规划为对照组,两组患者的性别、年龄、病情等一般资料比较,差异均无统计学意义(P>0.05)。比较两组患者术中实际安放假体与术前规划假体匹配情况、术中手术时间、术中出血量、术后即刻双侧股骨偏心距差值、双侧联合偏心距差值及双下肢长度差值和术后3个月Harris评分,分析两种术前规划的准确性和应用效果。结果与结论:①两组患者均获得术后4-6个月的随访,其中对照组有1例患者于术后5 d发生假体后脱位,行手法复位后恢复,无再次脱出,其余患者均未出现术后并发症及术后死亡;②髋臼侧、股骨侧假体完全匹配率:试验组明显优于对照组(P<0.05);③手术时间、术中出血量:试验组明显少于对照组(P<0.05);④两组患者术后双下肢长度差值比较差异有显著性意义(P<0.05),双侧股骨偏心距差值和双侧联合偏心距差值比较差异均无显著性意义(P>0.05);⑤试验组患者术后3个月Harris评分明显高于对照组患者(P<0.05);⑥结果说明,人工智能(AI)术前规划相较于传统胶片规划,更能准确预测假体型号、缩短手术时间、减少术中出血量、减少术后双下肢不等长发生、加快术后康复。
BACKGROUND:The preoperative planning of traditional X-ray films is often inaccurate,which can lead to some intraoperative and postoperative complications,increase the operation time and intraoperative blood loss,and to some extent affect the surgical outcome of total hip arthroplasty.OBJECTIVE:To investigate the accuracy and effectiveness of artificial intelligence preoperative planning in total hip arthroplasty METHODS:Sixty patients who underwent primary total hip arthroplasty on the affected side were selected.30 of them used artificial intelligence 3D preoperative planning(trial group)and 30 used conventional X-ray film 2D preoperative planning(control group),and there were no statistically significant differences between the two groups in terms of gender,age,condition and other general data(P>0.05).The actual intraoperative prosthesis placement and preoperative planning prosthesis matching,intraoperative operation time,intraoperative blood loss,bilateral femoral eccentric distance difference,bilateral joint eccentric distance difference and bilateral lower limb length difference,and Harris score at 3 months after operation were compared between the two groups,and the accuracy and application effect of the two preoperative plans were analyzed.RESULTS AND CONCLUSION:(1)Patients in both groups were followed up for 4-6 months postoperatively.One patient in the control group had a posterior dislocation of the prosthesis at 5 days postoperatively,which recovered after performing manual repositioning without re-dislodgement.The rest of the patients did not have postoperative complications or postoperative death.(2)Complete matching rate of the prosthesis on the acetabular side and femoral side was significantly better in the trial group than that in the control group(P<0.05).(3)Operation time and intraoperative blood loss were significantly less in the trial group than those in the control group(P<0.05).(4)The difference in bilateral lower limb length between the two groups was statistically significant(P<0.05),and the difference in bilateral femoral eccentric distance and bilateral joint eccentric distance was not statistically significant(P>0.05).(5)Harris score of patients in the trial group was significantly higher than that in the control group 3 months after operation(P<0.05).(6)These results confirm that compared with traditional film planning,artificial intelligence preoperative planning can predict the prosthesis type more accurately,shorten the operation time,reduce intraoperative blood loss,diminish the occurrence of postoperative bilateral lower limb inequality,and accelerate postoperative recovery.
作者
闵美鹏
吴进
URBA RAFI
张文杰
高嘉
王云华
何斌
范磊
Min Meipeng;Wu Jin;URBA RAFI;Zhang Wenjie;Gao Jia;Wang Yunhua;He Bin;Fan Lei(Department of Orthopedics,Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,Jiangsu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2024年第9期1372-1377,共6页
Chinese Journal of Tissue Engineering Research
基金
2022年江苏省卫健委老年健康科研项目(LKM2022008),项目负责人:范磊。
关键词
人工智能(AI)
全髋关节置换术
术前规划
模板测量
假体
artificial intelligence
total hip arthroplasty
preoperative planning
template measurement
prosthesis
