计算机手术导航系统对股骨头表面假体植入精确度的研究

目的研究非影像手术导航系统对股骨头表面假体植入位置的影响。方法25例股骨头坏死患者（共32髋）。其中男性16例，女性9例，年龄（36±7）岁。随机分为2组，计算机导航手术组（导航组）11例（16髋），在导航系统下进行股骨头表面置换术，设定髋最佳植入柄颈角为0°，柄干角为140°；对照组14例（16髋）采用传统手术。术后测定假体植入的角度，进行手术评估。结果术后导航组植入股骨假体柄干角为（140．5±1．7）°，对照组为（135．9±6．5）°，导航组的股骨假体柄颈角为（O．30±1．40）°，对照组柄颈角为（-4．93±4．30）°，两组差异具有统计学意义（P〈0．05）。Harris评分，导航组优14髋，良2髋；对照组优9髋，良4髋，中3髋。导航组无一例发生肢体缩短、旋转、内外翻畸形，对照组2例发生短缩畸形，1例内翻15°畸形。随访（14±4）个月，均无假体松动、脱位。结论在非影像手术导航系统下手术操作可以精确地植入假体，减少假体松动的发生,具有重要的临床价值。

Study on implantation accuracy of femoral head surface prostheses placement with computer navigated surgery

Objective To study the accuracy of femoral head surface component placement by non-imaging assisted surgery. Methods A total of 25 patients with femoral head osteonecrosis （32 hips ）, male 16 and female 9 with mean age （36 ± 7） years, were randomly divided into 2 groups. In computer navigated surgery group 11 patients （ 16 hips） with femoral head osteonecrosis were operated with non-imaging computer navigated surgery. According to the design of the study ,the femoral component was placed in best stem-graft angle of 140° and stem-neck angle of 0°. The control group enrolled 14 patients （ 16 hips ） operated with conventional mechanically guided procedure. Postoperative component position was measured. Results In the computer navigated surgery group, stem-graft angle achieved （140.5 ± 1.7 ）° and stem-neck angle achieved （0.3 ±1.4）°. In the control group, stem-graft angle were （135.9 ± 6.5 ）° and stem-neck angle were （-4.93 ± 4.30）°. The difference of stem femoral angle was demonstrated statistically significant （P 〈 0.05）. Conclusion The femoral head surface prostheses can be in planted accurately by non-imaging computer navigated surgery. It can reduce prostheses flexible with important clinical value.