Предоперационное планирование артропластики тазобедренного сустава

Abstract

Preoperative planning of hip arthroplasty provides surgeons with a unique opportunity of thorough investigation of the patient’s anatomy, allows them to determine optimal implant size and position, as well as to prevent potential complication. Advances in digital technology enable expansion of opportunities of preoperative planning due to using three-dimensional modeling. The study was aimed to compare precision of the three-step preoperative planning of hip arthroplasty and the standard method. Methods: The study involved 224 patients with various forms of degenerative and dystrophic diseases of the hip joint, who were divided into the index and control groups based on the planning method. In the index group, preoperative planning of arthroplasty was conducted in three steps: assessment of bone density in the zones of fixation based on CT; virtual design involving the use of automated programs; 3D model construction based on the computer model. X-ray images and endoprosthesis templates were used in the comparison group. The results showed that there were no significant differences between planning methods in patients with osteoarthrosis and avascular necrosis of the femoral head (p > 0.05), in contrast to the group with traumatic hip joint pathology showing significant differences (рс = 0.002). Conclusions: the three-step algorithm for preoperative planning of hip arthroplasty showed higher efficacy in patients with various nosological forms of degenerative and dystrophic diseases of the hip joint compared to the standard method.