虚拟现实模拟辅助肩峰成形术的初步结果△

Short- term outcomes of virtual reality simulation assisted arthroscopic acromioplasty for subacromial impingement

摘要:

［目的］比较术前影像虚拟与常规肩峰成形术的临床与影像结果。［方法］2019 年 3 月—2020 年 3 月，本院收治的肩关节撞击综合征患者 67 例纳入本研究。随机分为两组，模拟组 33 例，按术前影像虚拟规划肩峰成形；常规组 34 例，常规肩峰成形术。比较两组临床及影像结果。［结果］所有患者均顺利完成手术，两组手术时间的差异无统计学意义（P>0.05），模拟组术中骨赘切除长度显著大于常规组（P<0.05）。两组随访时间平均（6.83±1.59）个月。术后随时间推移，两组 UCLA 评分、ConstantMurley 评分均显著增加（P<0.05），术后 1 和 3 个月模拟组 UCLA 评分、Constant-Murley 评分显著优于常规组（P<0.05）。影像方面，两组术后 ASA、ACH 显著减小（P<0.05），而 AHD 显著增加（P<0.05），术后模拟组的 ASA 显著小于常规组（P<0.05），而两组间 ACH、AHD 的差异均无统计学意义（P>0.05）。［结论］术前影像虚拟规划肩峰成形术，能够帮助术中判断切除范围，有利于术后肩关节功能恢复。

Abstract:

[Objective] To compare the clinical and imaging results of preoperative virtual reality simulation assisted arthroscopic ac- romioplasty (VRSAA) versus conventional arthroscopic acromioplasty (CAA) . [Methods] From March 2019 to March 2020, 67 patients with subacromial impingement were enrolled in this study, and were randomly divided into two groups. Of them, 33 patients were given the VR- SAA, while the other 34 received CAA. The clinical and imaging consequences were compared between the two groups. [Results] All pa- tients had operations finished successfully with no significant difference in the operative time between the two groups (P＜0.05) , however, the VRSAA group had significantly larger osteophyte in length resected than the CAA group (P＜0.05) . As time went in the follow-up period last- ed for (6.83±1.59) months on an average, the UCLA score and Constant-Murley score increased significantly in both groups (P＜0.05) , which in the VRSAA group were significantly better than CAA group at 1 and 3 months postoperatively (P＜0.05) . Regarding to imaging evaluation, the acromial slope angle (ASA) and acromial curvature height (ACH) significantly decreased (P＜0.05) , whereas the acromiohumeral intervals distance (AHD) significantly increased postoperatively in both groups compared with those preoperatively (P＜0.05) . The VRSAA had signifi- cantly lower ASA than that in the CAA group (P＜0.05) , despite of the fact that no significant differences were noticed in ACH and AHD be- tween the two groups postoperatively (P＜0.05) . [Conclusion] This preoperative virtual reality simulation assisted arthroscopic acromioplas- ty does help determine the intraoperative resection range, and is conducive to postoperative shoulder function recovery.