Effectiveness analysis of revision surgery after total hip arthroplasty assisted by artificial intelligence preoperative planning system_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHU Jiaqing ¹ , SUN Jiahao ¹ , LIU Jinzhu ² , MA Bowen ¹ , ZHANG Chiyu ¹ , ZHANG Chao ¹ ,  XIA Tianwei ¹ ,  SHEN Jirong ¹ , ZHU Jiaqing ¹ , SUN Jiahao ¹ , LIU Jinzhu ² , MA Bowen ¹ , ZHANG Chiyu ¹ , ZHANG Chao ¹ ,  XIA Tianwei ¹ ,  SHEN Jirong ¹

1. Department of Orthopaedics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing Jiangsu, 210029, P. R. China;
2. Department of Orthopaedics, Changzhou Hospital of Traditional Chinese Medicine, Changzhou Jiangsu, 213004, P. R. China;

Corresponding author：

XIA Tianwei, Email: 1263638610@qq.com; SHEN Jirong, Email: joint66118@sina.com; XIA Tianwei, Email: 1263638610@qq.com; SHEN Jirong, Email: joint66118@sina.com

Keywords：

Artificial intelligence; preoperative planning; total hip arthroplasty; revision surgery

DOI：

10.7507/1002-1892.202312099

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Objective To explore the short-term effectiveness of hip revision surgery guided by artificial intelligence preoperative planning (AIHIP) system. Methods The clinical data of 22 patients (23 hips) who were admitted between June 2019 and March 2023 and met the selection criteria were retrospectively analyzed. There were 12 males and 10 females with an average age of 69.7 years (range, 44-90 years). There were 19 hips in the first revision, 3 hips in the second revision, and 1 hip in the third revision. The causes of revision included 12 hips with prosthesis loosening, 4 hips with acetabular cup loosening, 3 hips with osteolysis, 2 hips with acetabular dislocation, 1 hip with postoperative infection, and 1 hip with prosthesis wear. There were 6 hips in stage ⅡA, 9 hips in stage ⅡB, 4 hips in stage ⅡC, 3 hips in stage ⅢA, and 1 hip in stage ⅢB according to Paprosky staging of acetabular bone defect. The replacement of prosthesis type, operation time, hospitalization stay, ground active condition, and postoperative infection, fracture, prosthesis loosening, and other adverse events were recorded. The function of the affected limb was evaluated by Harris score before operation, at 1 week and 6 months after operation, and the range of motion of the hip joint was compared before operation and at 6 months after operation. Results The operation time was 85-510 minutes, with an average of 241.8 minutes; the hospitalization stay was 7-35 days, with an average of 15.2 days; the time of disassociation from the walker was 2-108 days, with an average of 42.2 days. All the 22 patients were followed up 8-53 months (mean, 21.7 months). No adverse events such as prosthesis loosening or infection occurred in the rest of the patients, except for postoperative hematoma of the thigh in 1 patient and dislocation of the hip in 1 hip. The matching degree of acetabular cup was completely matched in 22 hips and mismatched in 1 hip (+2), the matching rate was 95.65%. The matching degree of femoral stem was completely matched in 22 hips and generally matched in 1 hip (−1), and the matching rate was 100%. The Harris scores were 55.3±9.8 and 89.6±7.2 at 1 week and 6 months after operation, respectively, which significantly improved when compared with before operation (33.0±8.6, P<0.05), and further improved at 6 months after operation than at 1 week after operation (P<0.05). The function of hip joint was evaluated by Harris score at 6 months after operation, and 21 hips were good and 2 hips were moderate, which could meet the needs of daily life. The range of motion of hip joint was (111.09±10.11)° at 6 months after operation, which was significantly different from (79.13±18.50)° before operation (t=−7.269, P<0.001). Conclusion AIHIP system can improve the accuracy of revision surgery, reduce the difficulty of surgery, and achieve good postoperative recovery and satisfactory short-term effectiveness.

Citation： ZHU Jiaqing, SUN Jiahao, LIU Jinzhu, MA Bowen, ZHANG Chiyu, ZHANG Chao, XIA Tianwei, SHEN Jirong. Effectiveness analysis of revision surgery after total hip arthroplasty assisted by artificial intelligence preoperative planning system. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(4): 455-460. doi: 10.7507/1002-1892.202312099 Copy

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2. Deirmengian GK, Zmistowski B, O’Neil JT, et al. Management of acetabular bone loss in revision total hip arthroplasty. J Bone Joint Surg (Am), 2011, 93(19): 1842-1852.
3. 边焱焱, 程开源, 常晓, 等. 2011至2019年中国人工髋膝关节置换手术量的初步统计与分析. 中华骨科杂志, 2020, 40(21): 1453-1460.
4. 边焱焱, 程开源, 常晓, 等. 2011至2019年中国人工髋膝关节置换手术量的初步统计与分析. 中华骨科杂志, 2020, 40(21): 1453-1460.
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7. 刘珂, 刘晓潭, 侯毅, 等. 3D打印个体化髋臼填充技术在复杂髋关节翻修中的应用. 中华实验外科杂志, 2017, 34(3): 522-523.
8. 刘珂, 刘晓潭, 侯毅, 等. 3D打印个体化髋臼填充技术在复杂髋关节翻修中的应用. 中华实验外科杂志, 2017, 34(3): 522-523.
9. 赵玉峰, 王爱民, 孙红振, 等. 人工全髋关节置换术后感染翻修30例. 中华创伤杂志, 2006, 22(11): 815-819.
10. 赵玉峰, 王爱民, 孙红振, 等. 人工全髋关节置换术后感染翻修30例. 中华创伤杂志, 2006, 22(11): 815-819.
11. Mouchti S, Whitehouse MR, Sayers A, et al. The association of body mass index with risk of long-term revision and 90-day mortality following primary total hip replacement: Findings from the national joint registry for england, wales, northern ireland and the isle of man. J Bone Joint Surg (Am), 2018, 100(24): 2140-2152.
12. Mouchti S, Whitehouse MR, Sayers A, et al. The association of body mass index with risk of long-term revision and 90-day mortality following primary total hip replacement: Findings from the national joint registry for england, wales, northern ireland and the isle of man. J Bone Joint Surg (Am), 2018, 100(24): 2140-2152.
13. 杨泊宁, 陈骁, 代志鹏, 等. 部分旷置二期翻修术治疗人工髋关节假体周围感染. 中国骨与关节损伤杂志, 2019, 34(12): 1271-1273.
14. 杨泊宁, 陈骁, 代志鹏, 等. 部分旷置二期翻修术治疗人工髋关节假体周围感染. 中国骨与关节损伤杂志, 2019, 34(12): 1271-1273.
15. Ullmark G. The unstable total hip arthroplasty. EFORT Open Rev, 2017, 1(4): 83-88.
16. Ullmark G. The unstable total hip arthroplasty. EFORT Open Rev, 2017, 1(4): 83-88.
17. Di Martino A, Castagnini F, Stefanini N, et al. Survival rates and reasons for revision of different stem designs in total hip arthroplasty for developmental dysplasia: a regional registry study. J Orthop Traumatol, 2021, 22(1): 29. doi: 10.1186/s10195-021-00590-y.
18. Di Martino A, Castagnini F, Stefanini N, et al. Survival rates and reasons for revision of different stem designs in total hip arthroplasty for developmental dysplasia: a regional registry study. J Orthop Traumatol, 2021, 22(1): 29. doi: 10.1186/s10195-021-00590-y.
19. Ehlinger M, Delaunay C, Karoubi M, et al. Revision of primary total hip arthroplasty for peri-prosthetic fracture: A prospective epidemiological study of 249 consecutive cases in France. Orthop Traumatol Surg Res, 2014, 100(6): 657-662.
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Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness analysis of revision surgery after total hip arthroplasty assisted by artificial intelligence preoperative planning system

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