中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (27): 7101-7107.doi: 10.12307/2026.856

• 人工假体Artificial prosthesis • 上一篇    下一篇

HoloLens 2设备辅助精准放置髋臼侧假体对不同年资医师学习曲线的影响

夏庆泉，吴旭华，殷叶林，徐  青，孟祥超，容  可   

  1. 复旦大学附属闵行医院骨科，上海市闵行区中心医院骨科，复旦大学医学院，上海市  201199
  • 收稿日期:2025-10-29 接受日期:2026-01-21 出版日期:2026-09-28 发布日期:2026-05-14
  • 通讯作者: 孟祥超，博士，主治医师，复旦大学附属闵行医院骨科，上海市闵行区中心医院骨科，复旦大学医学院，上海市 201199 容可，博士，主任医师，复旦大学附属闵行医院骨科，上海市闵行区中心医院骨科，复旦大学医学院，上海市 201199
  • 作者简介:夏庆泉，男，1982年生，上海市人，汉族，2008年上海交通大学毕业，硕士，副主任医师，主要从事混合现实技术在骨科治疗及教学中的应用研究。
  • 基金资助:
    上海市闵行区自然科学研究课题(2025MHZ084)，项目负责人：容可；2025年中国高校产学研创新基金-产业协会智慧医疗创新专项(2025XH025)，项目负责人：容可

Impact of HoloLens 2–assisted navigation for precision acetabular cup placement on the learning curve of surgeons with different levels of experience

Xia Qingquan, Wu Xuhua, Yin Yelin, Xu Qing, Meng Xiangchao, Rong Ke   

  1. Department of Orthopedics of Minhang Hospital Affiliated to Fudan University, Department of Orthopedics of Minhang District Central Hospital, Fudan University School of Medicine, Shanghai 201199, China

  • Received:2025-10-29 Accepted:2026-01-21 Online:2026-09-28 Published:2026-05-14
  • Contact: Meng Xiangchao, MD, Attending physician, Department of Orthopedics of Minhang Hospital Affiliated to Fudan University, Department of Orthopedics of Minhang District Central Hospital, Fudan University School of Medicine, Shanghai 201199, China Rong Ke, MD, Chief physician, Department of Orthopedics of Minhang Hospital Affiliated to Fudan University, Department of Orthopedics of Minhang District Central Hospital, Fudan University School of Medicine, Shanghai 201199, China
  • About author:Xia Qingquan, MS, Associate chief physician, Department of Orthopedics of Minhang Hospital Affiliated to Fudan University, Department of Orthopedics of Minhang District Central Hospital, Fudan University School of Medicine, Shanghai 201199, China
  • Supported by:
    Shanghai Minhang District Natural Science Research Project, No. 2025MHZ084 (to RK); 2025 China University-Industry-Research Innovation Fund - Industry Association Smart Healthcare Innovation Project, 2025XH025 (to RK)

PDF

1

摘要：

文题释义：

安全区：Lewinnek安全区是髋关节置换术中臼杯放置的经典标准：外展角(40±10) °、前倾角(15±10) °，可显著降低术后脱位风险(脱位率从6.5%降至1.5%)。该范围通过平衡假体活动度与稳定性避免撞击和边缘负荷。近年研究提出的功能性安全区需结合脊柱-骨盆参数动态调整(如站立/坐姿变化)，且肥胖患者需增大前倾角(5°-10°)。严格遵循安全区可使假体10年存活率达95%以上，但仍需个体化设计以应对解剖变异。
混合现实：是虚拟现实与增强现实的融合技术，通过实时叠加全息影像于真实场景，实现虚拟物体与物理环境的深度交互。核心特点是虚实共生、动态响应(如手势操控虚拟模型)。在医疗领域，以 HoloLens 2为代表的设备可辅助手术导航(如髋臼假体精准放置，角度偏差≤1.5°)、远程协作及教学培训，突破传统二维影像局限。

摘要
背景：髋关节置换手术中安全、准确放置髋臼侧假体存在较长的手术学习曲线。混合现实技术可将虚拟图像数据模型与现实患者实体融合，有助于虚拟手术及术中导航等操作，或可提高髋臼侧假体放置准确性，缩短低年资医师手术学习曲线。
目的：利用HoloLens 2开发预设髋臼侧假体正确放置的位置数据和体外3D打印的骨盆髋臼模型进行手术操作，以明确混合现实技术在髋关节置换过程中培训及导引的作用效果。
方法：选择高年资有关节置换手术经验和低年资无臼杯放置经验的骨科医师，利用体外3D打印骨盆髋臼模型分别在徒手或者HoloLens 2头戴设备引导下进行关节置换的体外手术操作，测量并记录髋臼侧假体置入后的外展角及前倾角，比较髋臼侧假体放置角度准确性的差异。
结果与结论：①徒手操作条件下，有经验医师组臼杯外展角为(41.52±3.76)°、前倾角为(21.35±3.63)°；无经验医师组外展角为(44.29±7.62)°、
前倾角为(21.55±7.82)°，两组放置角度结果差异均有显著性意义(P < 0.05)；②使用HoloLens设备辅助后，无经验医师组中外展角和前倾角分别为(41.10±1.28)°和(20.09±0.53)°，有经验医师组中外展角和前倾角分别为(41.08±1.09)°和(20.28±0.65)°，两组之间无明显差异；③提示对于全髋置换，应用混合现实技术辅助时，医师在臼杯放置角度的控制精度上显著优于徒手操作，应用混合现实技术辅助对于医生精确磨锉髋臼并放置臼杯具有明显的临床辅助价值，能够缩短骨科医师手术操作的学习曲线。



中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 混合现实技术, HoloLens 2, 髋关节置换, 髋臼假体, 学习曲线, 手术导引

Abstract: BACKGROUND: There is a long surgical learning curve for safe and accurate placement of the acetabular prosthesis in hip replacement surgery. Mixed reality technology can fuse virtual image data models with real patient entities, which can help operations such as virtual surgery and intraoperative navigation, potentially improving the accuracy of acetabular prosthesis placement and shortening the surgical learning curve for less experienced surgeons.
OBJECTIVE: To develop positional data for the accurate placement of acetabular components via HoloLens 2, and conduct surgical operations in combination with an in-vitro 3D-printed pelvic acetabular model, so as to clarify the efficacy of mixed reality technology in both training and intraoperative guidance for hip replacement surgery.  
METHODS: Orthopedic surgeons with extensive experience in joint replacement surgery and those with limited experience in acetabular cup placement were recruited to perform in vitro surgical operations for joint replacement using an in vitro 3D printed pelvic acetabular model under conventional surgical operation and/or guided by HoloLens 2 head-mounted device, respectively. The abduction angle, the anteversion angle, the offset degree of the acetabular prosthesis were measured and recorded to compare the differences in the accuracy of acetabular component placement angles. 
RESULTS AND CONCLUSION: (1) Under manual operation conditions, the experienced surgeon group had an acetabular cup abduction angle of (41.52±3.76)° and an anteversion angle of (21.35±3.63)°; the inexperienced surgeon group had an abduction angle of (44.29±7.62)° and an anteversion angle of (21.55±7.82)°. The differences in placement angles between the two groups were statistically significant (P < 0.05). (2) After using the HoloLens device for assistance, the inexperienced surgeon group had abduction and anteversion angles of (41.10±1.28)° and (20.09±0.53)°, respectively, while the experienced surgeon group had abduction and anteversion angles of (41.08±1.09)° and (20.28±0.65)°, respectively. There was no significant difference between the two groups. (3) This suggests that for total hip replacement, the use of mixed reality technology significantly improves the accuracy of acetabular cup placement compared with manual operation. The application of mixed reality technology provides significant clinical assistance for surgeons in precisely reaming the acetabulum and placing the acetabular cup, and can shorten the learning curve for orthopedic surgeons. 

Key words: ">mixed reality technology, HoloLens 2, hip replacement, acetabular prosthesis, learning curve, surgical navigation

中图分类号: