基于智能规划与导航技术辅助的髋关节镜下盂唇缝合术:病例报告1 例及文献复习

Arthroscopic labral repair assisted by intelligent planning and navigation technology in hip joint: A case report and literature review

  • 摘要: 背景 髋关节镜下带线锚钉修复盂唇存在较高的软骨穿透风险。计算机导航技术可提升手术的精准性和安全性,但其应用于髋关节镜下盂唇缝合的报道较少。目的 分析1 例行计算机导航技术辅助髋关节镜下盂唇缝合病例的病例资料,评估该方法的安全性和准确性。方法 1 例28 岁男性患者因凸轮型股骨髋臼撞击征(femoroacetabular impingement,FAI)伴盂唇损伤(labral tear,LT)及髋臼囊肿于2025 年8 月在解放军总医院第四医学中心运动医学科住院,采用自主研发的智能规划与导航系统进行术前三维规划和术中实时引导,术后通过CT评估锚钉置入位置,以“锚钉未穿透至关节软骨下骨或骨盆侧”作为安全性评价指标,以“锚钉实际置入距离和角度与术前规划的一致性”作为精准性评价指标。结果 成功完成缝线锚钉精准置入与盂唇修复,有效避开髋臼骨内囊肿。共置入锚钉4 枚,均处于术前规划角度范围内,实际置钉角度平均为(39.32±8.49)°。锚钉插入点至关节软骨下骨的平均距离(2.58±0.50) mm接近术前规划(平均2.05±0.14) mm。结论 智能规划与导航技术辅助的髋关节镜下盂唇缝合术安全可靠,在髋臼前缘等高穿透风险部位优势显著,有助于降低穿孔风险,具有较高的临床推广价值和患者获益前景。

     

    Abstract: Background Hip arthroscopic labral repair using suture anchors carries a relatively high risk of cartilage penetration. While computer navigation technology has the potential to enhance surgical precision and safety, reports on its application in hip arthroscopic labral suturing remain scarce. Objective To explore the clinical advantages of intelligent planning and navigation technology in assisting suture anchor placement during hip arthroscopy for labral repair, and evaluate its safety and accuracy. Methods In August 2025, a 28-year-old male patient with cam-type femoroacetabular impingement (FAI) accompanied by a labral tear (LT) and an acetabular cyst was admitted to the Department of Sports Medicine of the Fourth Medical Center of PLA General Hospital. A self-developed intelligent planning and navigation system was employed for preoperative three-dimensional planning and intraoperative real-time guidance. Postoperatively, CT was used to evaluate the position of the suture anchors, with "no anchor penetration into the subchondral bone of the joint or the pelvic side" adopted as the safety evaluation criterion, and "the consistency between the actual insertion distance and angle of the anchors and the preoperative plan" used as the accuracy evaluation criterion. Results The precise placement of the suture anchor and labral repair was successfully completed, effectively avoiding the intraosseous cyst within the acetabulum. A total of 4 anchor screws were placed, all within the safe angle range planned preoperatively. The average actual placement angle was (39.32±8.49)°. The average distance from the anchor insertion point to the subchondral bone of the joint (2.58±0.50) mm was close to the preoperative planning (average 2.05±0.14) mm. Conclusion  Arthroscopic labral repair assisted by intelligent planning and navigation technology is safe and reliable especially in high-risk areas such as the anterior acetabular rim, which helps reduce the risk of perforation and has high clinical promotion value and patient benefit prospects.

     

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