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Article(id=1320441214789337685, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1320441010094715145, articleNumber=null, orderNo=null, doi=10.16016/j.2097-0927.202512155, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1766937600000, receivedDateStr=2025-12-29, revisedDate=1769875200000, revisedDateStr=2026-02-01, acceptedDate=null, acceptedDateStr=null, onlineDate=1792747318217, onlineDateStr=2026-10-23, pubDate=1774800000000, pubDateStr=2026-03-30, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792747318217, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792747318217, creator=13701087609, updateTime=1792747318217, updator=13701087609, issue=Issue{id=1320441010094715145, tenantId=1146029695717560320, journalId=1319373162502258839, year='2026', volume='48', issue='6', pageStart='663', pageEnd='830', issueExtLink='null', onlineDate='null', pubDate='1774800000000', pubDateStr='2026-03-30', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792747269413, creator='13701087609', updateTime=1792749761919, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320451464481321472, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1320441010094715145, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320451464481321473, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1320441010094715145, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=822, endPage=830, ext={EN=ArticleExt(id=1320441215259099737, articleId=1320441214789337685, tenantId=1146029695717560320, journalId=1319373162502258839, language=EN, title=Superior performance of artificial intelligence-assisted preoperative planning for total knee arthroplasty in patients under 60 years: a retrospective cross-sectional comparative study, columnId=1320435198676816706, journalTitle=Journal of Army Medical University, columnName=Intelligent Medicine and Prediction Model, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate whether the accuracy of artificial intelligence (AI)-assisted preoperative planning for total knee arthroplasty (TKA) is non-inferior to computer-assisted manual preoperative planning completed collaboratively by 3D engineers and orthopedic surgeons, and to evaluate the impact of age on the accuracy of AI-based planning.

Methods

This study adopted a retrospective, cross-sectional comparative design. Data were retrospectively collected from 127 patients who underwent TKA at the First Affiliated Hospital of Army Medical University between December 2022 and September 2023. They were divided into a ≤60 years group (40 to 60 years old, n=22) and an >60 years group (61 to 80 years old, n=105) based on age. All patients underwent both AI-assisted preoperative planning (AI planning) and computer-assisted manual preoperative planning (conventional planning). Hip-knee-shaft angle (HKS), femoral resection difference, tibial resection difference, femoral rotation angle, and prosthesis size data from AI planning, conventional planning, and actual intraoperative measurements, as well as time, manpower, and economic costs of AI planning and conventional planning were compared between the 2 planning methods. The non-inferiority margin was set as resection angle difference ≤1°, resection thickness difference ≤1 mm, and prosthesis size difference ≤1.

Results

Compared with the conventional planning, the AI planning showed a mean increase of 0.8°±1.2° in HKS (Cohen’s d=0.4, 95%CI: 0.2 to 0.7), a mean increase of 1.1±1.8 mm in femoral resection difference (Cohen’s d=0.5, 95%CI: 0.3 to 0.8), and a mean increase of 0.6±1.7 mm in tibial resection difference (Cohen’s d=0.3, 95%CI: 0.0 to 0.5). The lower limits of 95%CI for these above standardized mean differences were all greater than their corresponding negative non-inferiority margins. In comparison with the conventional planning, the AI planning in the ≤60 years group showed no significant differences in HKS, tibial resection difference, and femoral rotation angle (P>0.05), whereas in the >60 years group, only femoral resection difference of AI planning exceeded the non-inferiority margin (with a mean increase of 1.1 mm, P<0.05). For prosthesis size prediction, the AI planning achieved 73.2% femoral prosthesis and 87.4% tibial prosthesis predictions with size differences not exceeding 1, while conventional planning achieved 81.9% femoral prosthesis and 90.6% tibial prosthesis predictions with size differences not exceeding 1, with no significant difference between the 2 planning methods (P>0.05). The time consumed for AI planning was significantly shorter than that for conventional planning (27.4±4.1 vs 45.3±8.5 min, P<0.05). Moreover, AI planning required no additional labor and equipment costs, with no additional manpower or equipment costs (0 vs 3 000 Yuan/case).

Conclusion

AI-assisted preoperative planning for TKA s demonstrates non-inferior accuracy compared with conventional planning, with superior performance particularly in patients under 60 years, and significant advantages in time and economic costs.

, authors=Ke ZENG1, Shangwei YU1, Liming LIU2, Lin GUO1, authorsList=Ke ZENG, Shangwei YU, Liming LIU, Lin GUO, authorCompany=null, correspAuthors=Liming LIU, Lin GUO, authorNote=null, correspAuthorsNote=null, copyrightStatement=© 2026 Journal of Army Medical University, copyrightOwner=Editorial Office of Journal of Army Medical University, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1320441219847668330, articleId=1320441214789337685, tenantId=1146029695717560320, journalId=1319373162502258839, language=CN, title=人工智能辅助全膝关节置换术前规划在60岁以下患者中的优势表现：一项回顾性横断面对比研究, columnId=1320435199041721156, journalTitle=陆军军医大学学报, columnName=智能医学与预测模型, runingTitle=null, highlight=null, articleAbstract=
目的

探究人工智能（artificial intelligence， AI）辅助全膝关节置换（total knee arthroplasty， TKA）术前规划的准确性是否不劣于三维工程师和医生合作完成的人工TKA术前规划，并评估年龄对AI规划精准度的影响。

方法

本研究采用回顾性、横断面比较设计，回顾性收集127名在2022年12月至2023年9月于陆军军医大学第一附属医院行TKA的患者资料，根据年龄分为≤60岁组（40-60岁，n=22）和>60岁组（61~80岁，n=105）。对所有患者分别进行AI辅助术前规划（AI规划）与计算机辅助人工术前规划（传统规划）。对比患者AI规划、传统规划及术中真实的股骨远端截骨角（hip-knee-shaft angle， HKS）、股骨截骨差、胫骨截骨差、股骨旋转角和假体型号数据，以及AI规划和传统规划的时间、人力及经济成本。非劣效界值设定为截骨角度差≤1°、截骨厚度差≤1 mm、假体型号差≤1个。

结果

与传统规划相比，AI规划HKS平均偏大（0.8±1.2）°，Cohen’s d =0.4（95%CI：0.2~0.7）；股骨截骨差平均偏大（1.1±1.8） mm，Cohen’s d=0.5（95%CI为0.3~0.8）；胫骨截骨差平均偏大（0.6±1.7）mm，Cohen’s d =0.3（95%CI为0~0.5），以上“标准化平均差异”的95%CI下限均大于其“负的非劣效界值”。与传统规划相比，≤60岁组AI规划在HKS、胫骨截骨差和股骨旋转角无显著差异（P>0.05），>60岁组AI规划仅股骨截骨差的差异超过非劣效性界值（平均偏大1.1 mm，P<0.05）。假体型号预测方面，AI规划有73.2%的股骨假体和87.4%的胫骨假体预测型号差异未超过1个型号，传统规划有81.9%的股骨假体和90.6%的胫骨假体预测型号差异未超过1个型号，二者无显著差异。AI规划耗时显著短于传统规划［（27.4±4.1） min vs. （45.3±8.5） min，P<0.05］，且无需额外人力与设备成本（患者费用为0元/例vs. 3 000元/例）。

结论

TKA的AI术前规划具有不劣于传统规划模式的精准度，尤其在60岁以下患者中表现更优，同时具备显著的时间与经济成本优势。

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刘力铭，E-mail：
郭林，E-mail：
LIU Liming，E-mail：
GUO Lin，E-mail：
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orderNo=3, keyword=术前规划), Keyword(id=1320441232472523412, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=CN, orderNo=4, keyword=精准度), Keyword(id=1320441232531243669, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=CN, orderNo=5, keyword=下肢对线)], refs=[Reference(id=1320441241209258672, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1016/s0030-5898（05）70231-5, pmid=null, pmcid=null, year=2001, volume=32, issue=4, pageStart=611, pageEnd=626, url=null, language=null, rfNumber=1, rfOrder=0, authorNames=ROBBINS G M, MASRI B A, GARBUZ D S, journalName=Orthop Clin North Am, refType=null, unstructuredReference=ROBBINS G M， MASRI B A， GARBUZ D S， et al. Preoperative planning to prevent instability in total knee arthroplasty［J］. Orthop Clin North Am， 2001， 32（4）： 611-626， viii., articleTitle=Preoperative planning to prevent instability in total knee arthroplasty, refAbstract=null), Reference(id=1320441241335087793, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1016/j.arth.2015.02.021, pmid=null, pmcid=null, year=2015, volume=30, issue=7, pageStart=1250, pageEnd=1253, url=null, language=null, rfNumber=2, rfOrder=1, authorNames=GOYAL N, STULBERG S D, journalName=J Arthroplasty, refType=null, unstructuredReference=GOYAL N， STULBERG S D. Evaluating the precision of preoperative planning in patient specific instrumentation： can a single MRI yield different preoperative plans？［J］. J Arthroplasty， 2015， 30（7）： 1250-1253., articleTitle=Evaluating the precision of preoperative planning in patient specific instrumentation： can a single MRI yield different preoperative plans？, refAbstract=null), Reference(id=1320441241628689074, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.15912/j.cnki.gocm.2018.31.021, pmid=null, pmcid=null, year=2018, volume=16, issue=31, pageStart=31, pageEnd=34, url=null, language=null, rfNumber=3, rfOrder=2, authorNames=文材, 尹立, journalName=中国医药指南, refType=null, unstructuredReference=文材， 尹立. 人工膝关节置换术的发展概况与进展［J］. 中国医药指南， 2018， 16（31）： 31-34., articleTitle=人工膝关节置换术的发展概况与进展, refAbstract=null), Reference(id=1320441241695797939, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.15912/j.cnki.gocm.2018.31.021, pmid=null, pmcid=null, year=2018, volume=16, issue=31, pageStart=31, pageEnd=34, url=null, language=null, rfNumber=3, rfOrder=3, authorNames=WEN C, YIN L, journalName=Guide China Med, refType=null, unstructuredReference=WEN C，YIN L. Development and progress of artificial knee replacement［J］. Guide China Med， 2018， 16（31）： 31-34., articleTitle=Development and progress of artificial knee replacement, refAbstract=null), Reference(id=1320441241767101108, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1186/s13018-022-03115-3, pmid=null, pmcid=null, year=2022, volume=17, issue=1, pageStart=227, pageEnd=null, url=null, language=null, rfNumber=4, rfOrder=4, authorNames=LEI K, LIU L M, YANG P F, journalName=J Orthop Surg Res, refType=null, unstructuredReference=LEI K， LIU L M， YANG P F， et al. Robotics versus personalized 3D preoperative planning in total knee arthroplasty： a propensity score-matched analysis［J］. J Orthop Surg Res， 2022， 17（1）： 227., articleTitle=Robotics versus personalized 3D preoperative planning in total knee arthroplasty： a propensity score-matched analysis, refAbstract=null), Reference(id=1320441241830015669, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1111/os.13365, pmid=null, pmcid=null, year=2022, volume=14, issue=8, pageStart=1681, pageEnd=1694, url=null, language=null, rfNumber=5, rfOrder=5, authorNames=HE R, SUN M L, XIONG R, journalName=Orthop Surg, refType=null, unstructuredReference=HE R， SUN M L， XIONG R， et al. A newly designed “SkyWalker” robot applied in total knee arthroplasty： a retrospective cohort study for femoral rotational alignment restoration［J］. Orthop Surg， 2022， 14（8）： 1681-1694., articleTitle=A newly designed “SkyWalker” robot applied in total knee arthroplasty： a retrospective cohort study for femoral rotational alignment restoration, refAbstract=null), Reference(id=1320441242056508086, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.13795/j.cnki.sgkz.2021.10.017, pmid=null, pmcid=null, year=2021, volume=27, issue=10, pageStart=941, pageEnd=946， 950, url=null, language=null, rfNumber=6, rfOrder=6, authorNames=刘国彬, 刘森, 王立飞, journalName=实用骨科杂志, refType=null, unstructuredReference=刘国彬， 刘森， 王立飞， 等. 一种基于“H”点的全新3D打印个性化截骨导板辅助胫骨高位截骨术的尸体研究［J］. 实用骨科杂志， 2021， 27（10）： 941-946， 950., articleTitle=一种基于“H”点的全新3D打印个性化截骨导板辅助胫骨高位截骨术的尸体研究, refAbstract=null), Reference(id=1320441242123616951, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.13795/j.cnki.sgkz.2021.10.017, pmid=null, pmcid=null, year=2021, volume=27, issue=10, pageStart=941, pageEnd=946， 950, url=null, language=null, rfNumber=6, rfOrder=7, authorNames=LIU G B, LIU S, WANG L F, journalName=J Pract Orthop, refType=null, unstructuredReference=LIU G B，LIU S， WANG L F， et al. A novel 3D-printed patient-specific instrument based on “H” point for medial opening-wedge high tibial osteotomy： a cadaver study［J］. J Pract Orthop， 2021， 27（10）： 941-946， 950., articleTitle=A novel 3D-printed patient-specific instrument based on “H” point for medial opening-wedge high tibial osteotomy： a cadaver study, refAbstract=null), Reference(id=1320441242471744184, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1007/s00167-022-07035-x, pmid=null, pmcid=null, year=2022, volume=30, issue=8, pageStart=2535, pageEnd=2537, url=null, language=null, rfNumber=7, rfOrder=8, authorNames=VON EISENHART-ROTHE R, HINTERWIMMER F, GRAICHEN H, journalName=Knee Surg Sports Traumatol Arthrosc, refType=null, unstructuredReference=VON EISENHART-ROTHE R， HINTERWIMMER F， GRAICHEN H， et al. Artificial intelligence and robotics in TKA surgery： promising options for improved outcomes？［J］. Knee Surg Sports Traumatol Arthrosc， 2022， 30（8）： 2535-2537., articleTitle=Artificial intelligence and robotics in TKA surgery： promising options for improved outcomes？, refAbstract=null), Reference(id=1320441242551435961, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1007/s00167-022-07037-9, pmid=null, pmcid=null, year=2022, volume=30, issue=8, pageStart=2538, pageEnd=2547, url=null, language=null, rfNumber=8, rfOrder=9, authorNames=SCHWARZ G M, SIMON S, MITTERER J A, journalName=Knee Surg Sports Traumatol Arthrosc, refType=null, unstructuredReference=SCHWARZ G M， SIMON S， MITTERER J A， et al. Artificial intelligence enables reliable and standardized measurements of implant alignment in long leg radiographs with total knee arthroplasties［J］. Knee Surg Sports Traumatol Arthrosc， 2022， 30（8）： 2538-2547., articleTitle=Artificial intelligence enables reliable and standardized measurements of implant alignment in long leg radiographs with total knee arthroplasties, refAbstract=null), Reference(id=1320441242886980282, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1016/j.arth.2022.12.007, pmid=null, pmcid=null, year=2023, volume=38, issue=10, pageStart=2032, pageEnd=2036, url=null, language=null, rfNumber=9, rfOrder=10, authorNames=FERNANDES L R, ARCE C, MARTINHO G, journalName=J Arthroplasty, refType=null, unstructuredReference=FERNANDES L R， ARCE C， MARTINHO G， et al. Accuracy， reliability， and repeatability of a novel artificial intelligence algorithm converting two-dimensional radiographs to three-dimensional bone models for total knee arthroplasty［J］. J Arthroplasty， 2023， 38（10）： 2032-2036., articleTitle=Accuracy， reliability， and repeatability of a novel artificial intelligence algorithm converting two-dimensional radiographs to three-dimensional bone models for total knee arthroplasty, refAbstract=null), Reference(id=1320441242966672059, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1007/s00167-021-06753-y, pmid=null, pmcid=null, year=2023, volume=31, issue=4, pageStart=1524, pageEnd=1532, url=null, language=null, rfNumber=10, rfOrder=11, authorNames=LIU L M, LEI K, CHEN X, journalName=Knee Surg Phys Traumatol Arthrosc, refType=null, unstructuredReference=LIU L M， LEI K， CHEN X， et al. Proximal external femoral torsion increases lateral femoral shaft bowing： a study based on 3D CT reconstruction models［J］. Knee Surg Phys Traumatol Arthrosc， 2023， 31（4）： 1524-1532., articleTitle=Proximal external femoral torsion increases lateral femoral shaft bowing： a study based on 3D CT reconstruction models, refAbstract=null), Reference(id=1320441243398685372, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1016/j.knee. 2015. 12.004, pmid=null, pmcid=null, year=2016, volume=23, issue=2, pageStart=209, pageEnd=213, url=null, language=null, rfNumber=11, rfOrder=12, authorNames=NAKANO N, MATSUMOTO T, HASHIMURA M, journalName=Knee, refType=null, unstructuredReference=NAKANO N， MATSUMOTO T， HASHIMURA M， et al. Coronal lower limb alignment in normal knees： a radiographic analysis of 797 normal knee subjects［J］. Knee， 2016， 23（2）： 209-213., articleTitle=Coronal lower limb alignment in normal knees： a radiographic analysis of 797 normal knee subjects, refAbstract=null), Reference(id=1320441244988326591, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=null, pmid=null, pmcid=null, year=1993, volume=8, issue=5, pageStart=503, pageEnd=510, url=null, language=null, rfNumber=12, rfOrder=13, authorNames=OTANI T, WHITESIDE L A, WHITE S E, journalName=J Arthroplasty, refType=null, unstructuredReference=OTANI T， WHITESIDE L A， WHITE S E. Cutting errors in preparation of femoral components in total knee arthroplasty［J］. J Arthroplasty， 1993， 8（5）： 503-510., articleTitle=Cutting errors in preparation of femoral components in total knee arthroplasty, refAbstract=null), Reference(id=1320441245525197505, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1016/j.knee. 2018.04.011, pmid=null, pmcid=null, year=2018, volume=25, issue=4, pageStart=644, pageEnd=649, url=null, language=null, rfNumber=13, rfOrder=14, authorNames=HARUTA Y, KAWAHARA S, TSUCHIMOCHI K, journalName=Knee, refType=null, unstructuredReference=HARUTA Y， KAWAHARA S， TSUCHIMOCHI K， et al. Deviation of femoral intramedullary alignment rod influences coronal and sagittal alignment during total knee arthroplasty［J］. Knee， 2018， 25（4）： 644-649., articleTitle=Deviation of femoral intramedullary alignment rod influences coronal and sagittal alignment during total knee arthroplasty, refAbstract=null), Reference(id=1320441245831381700, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1016/S0968-0160（03）00106-6, pmid=null, pmcid=null, year=2004, volume=11, issue=3, pageStart=197, pageEnd=201, url=null, language=null, rfNumber=14, rfOrder=15, authorNames=KINZEL V, SCADDAN M, BRADLEY B, journalName=Knee, refType=null, unstructuredReference=KINZEL V， SCADDAN M， BRADLEY B， et al. Varus/Valgus alignment of the femur in total knee arthroplasty. Can accuracy be improved by pre-operative CT scanning？［J］. Knee， 2004， 11（3）： 197-201., articleTitle=Varus/Valgus alignment of the femur in total knee arthroplasty. Can accuracy be improved by pre-operative CT scanning？, refAbstract=null), Reference(id=1320441245919462085, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.3969/j.issn.1671-0800.2025.04.020, pmid=null, pmcid=null, year=2025, volume=37, issue=4, pageStart=405, pageEnd=407, url=null, language=null, rfNumber=15, rfOrder=16, authorNames=班吉鹤, 李鹏鹏, 彭礼禄, journalName=现代实用医学, refType=null, unstructuredReference=班吉鹤， 李鹏鹏， 彭礼禄， 等. 人工智能模拟技术在全膝关节置换术前规划中的应用［J］. 现代实用医学， 2025， 37（4）： 405-407., articleTitle=人工智能模拟技术在全膝关节置换术前规划中的应用, refAbstract=null), Reference(id=1320441246263395014, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.3969/j.issn.1671-0800.2025.04.020, pmid=null, pmcid=null, year=2025, volume=37, issue=4, pageStart=405, pageEnd=407, url=null, language=null, rfNumber=15, rfOrder=17, authorNames=BAN J H, LI P P, PENG L L, journalName=Mod Pract Med, refType=null, unstructuredReference=BAN J H， LI P P， PENG L L， et al. Application of artificial intelligence simulation technology in pre-planning of total knee replacement［J］. Mod Pract Med， 2025， 37（4）： 405-407., articleTitle=Application of artificial intelligence simulation technology in pre-planning of total knee replacement, refAbstract=null), Reference(id=1320441246334698186, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=null, pmid=null, pmcid=null, year=2024, volume=null, issue=1, pageStart=121, pageEnd=126, url=null, language=null, rfNumber=16, rfOrder=18, authorNames=杜浩源, 陈达伊, 姜嵩, journalName=中文科技期刊数据库（引文版）医药卫生, refType=null, unstructuredReference=杜浩源， 陈达伊， 姜嵩， 等. 人工智能三维规划辅助全膝关节置换术的研究［J］. 中文科技期刊数据库（引文版）医药卫生， 2024（1）： 121-126., articleTitle=人工智能三维规划辅助全膝关节置换术的研究, refAbstract=null), Reference(id=1320441246670242507, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=null, pmid=null, pmcid=null, year=2024, volume=null, issue=1, pageStart=121, pageEnd=126, url=null, language=null, rfNumber=16, rfOrder=19, authorNames=DU H Y, CHEN D Y, JIANG S, journalName=Chin Sci J Database（Cit Ed） Med Health, refType=null, unstructuredReference=DU H Y， CHEN D Y， JIANG S， et al. Study on artificial intelligence 3D planning assisted total knee arthroplasty［J］. Chin Sci J Database（Cit Ed） Med Health， 2024（1）： 121-126., articleTitle=Study on artificial intelligence 3D planning assisted total knee arthroplasty, refAbstract=null), Reference(id=1320441246737351373, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.2106/JBJS.H.00434, pmid=null, pmcid=null, year=2010, volume=92, issue=5, pageStart=1115, pageEnd=1121, url=null, language=null, rfNumber=17, rfOrder=20, authorNames=MAHONEY O M, KINSEY T, journalName=J Bone Joint Surg Am, refType=null, unstructuredReference=MAHONEY O M， KINSEY T. Overhang of the femoral component in total knee arthroplasty： risk factors and clinical consequences［J］. J Bone Joint Surg Am， 2010， 92（5）： 1115-1121., articleTitle=Overhang of the femoral component in total knee arthroplasty： risk factors and clinical consequences, refAbstract=null), Reference(id=1320441246825431759, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.3390/jcm13051255, pmid=null, pmcid=null, year=2024, volume=13, issue=5, pageStart=1255, pageEnd=null, url=null, language=null, rfNumber=18, rfOrder=21, authorNames=FACTOR S, GUREL R, DAN D, journalName=J Clin Med, refType=null, unstructuredReference=FACTOR S， GUREL R， DAN D， et al. Validating a novel 2D to 3D knee reconstruction method on preoperative total knee arthroplasty patient anatomies［J］. J Clin Med， 2024， 13（5）： 1255., articleTitle=Validating a novel 2D to 3D knee reconstruction method on preoperative total knee arthroplasty patient anatomies, refAbstract=null), Reference(id=1320441247148393168, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.7507/1002-1892.202005007, pmid=null, pmcid=null, year=2020, volume=34, issue=9, pageStart=1077, pageEnd=1084, url=null, language=null, rfNumber=19, rfOrder=22, authorNames=吴东, 刘星宇, 张逸凌, journalName=中国修复重建外科杂志, refType=null, unstructuredReference=吴东， 刘星宇， 张逸凌， 等. 人工智能辅助全髋关节置换术三维规划系统的研发及临床应用研究［J］. 中国修复重建外科杂志， 2020， 34（9）： 1077-1084., articleTitle=人工智能辅助全髋关节置换术三维规划系统的研发及临床应用研究, refAbstract=null), Reference(id=1320441247253250770, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.7507/1002-1892.202005007, pmid=null, pmcid=null, year=2020, volume=34, issue=9, pageStart=1077, pageEnd=1084, url=null, language=null, rfNumber=19, rfOrder=23, authorNames=WU D, LIU X Y, ZHANG Y L, journalName=Chin J Reparative Reconstr Surg, refType=null, unstructuredReference=WU D， LIU X Y， ZHANG Y L， et al. Research and application of artificial intelligence based three-dimensional preoperative planning system for total hip arthroplasty［J］. Chin J Reparative Reconstr Surg， 2020， 34（9）： 1077-1084., articleTitle=Research and application of artificial intelligence based three-dimensional preoperative planning system for total hip arthroplasty, refAbstract=null), Reference(id=1320441247316165331, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.3390/bioengineering10121417, pmid=null, pmcid=null, year=2023, volume=10, issue=12, pageStart=1417, pageEnd=null, url=null, language=null, rfNumber=20, rfOrder=24, authorNames=LI S L, LIU X Y, CHEN X, journalName=Bioengineering, refType=null, unstructuredReference=LI S L， LIU X Y， CHEN X， et al. Development and validation of an artificial intelligence preoperative planning and patient-specific instrumentation system for total knee arthroplasty［J］. Bioengineering， 2023， 10（12）： 1417., articleTitle=Development and validation of an artificial intelligence preoperative planning and patient-specific instrumentation system for total knee arthroplasty, refAbstract=null), Reference(id=1320441247567823572, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1055/s-0041-1728785, pmid=null, pmcid=null, year=2022, volume=35, issue=14, pageStart=1563, pageEnd=1570, url=null, language=null, rfNumber=21, rfOrder=25, authorNames=LIU L M, LEI K, CHEN X, journalName=J Knee Surg, refType=null, unstructuredReference=LIU L M， LEI K， CHEN X， et al. Is Valgus cut angle based on radiographic measurements in total knee arthroplasty really inaccurate？ a comparison of two- and three-dimensional measurements［J］. J Knee Surg， 2022， 35（14）： 1563-1570., articleTitle=Is Valgus cut angle based on radiographic measurements in total knee arthroplasty really inaccurate？ a comparison of two- and three-dimensional measurements, refAbstract=null), Reference(id=1320441249245545173, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1111/os.13545, pmid=null, pmcid=null, year=2022, volume=14, issue=12, pageStart=3209, pageEnd=3215, url=null, language=null, rfNumber=22, rfOrder=26, authorNames=LIU L M, LEI K, GUO L, journalName=Orthop Surg, refType=null, unstructuredReference=LIU L M， LEI K， GUO L， et al. Surgical transepicondylar axis is not a reliable reference when there was lateral femoral bowing［J］. Orthop Surg， 2022， 14（12）： 3209-3215., articleTitle=Surgical transepicondylar axis is not a reliable reference when there was lateral femoral bowing, refAbstract=null), Reference(id=1320441249350402775, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1055/s-0038-1668122, pmid=null, pmcid=null, year=2019, volume=32, issue=8, pageStart=742, pageEnd=749, url=null, language=null, rfNumber=23, rfOrder=27, authorNames=MARCHAND R C, SODHI N, BHOWMIK-STOKER M, journalName=J Knee Surg, refType=null, unstructuredReference=MARCHAND R C， SODHI N， BHOWMIK-STOKER M， et al. Does the robotic arm and preoperative CT planning help with 3D intraoperative total knee arthroplasty planning？［J］. J Knee Surg， 2019， 32（8）： 742-749., articleTitle=Does the robotic arm and preoperative CT planning help with 3D intraoperative total knee arthroplasty planning？, refAbstract=null), Reference(id=1320441249606255320, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.3760/cma.j.cn501098-20220322-00206, pmid=null, pmcid=null, year=2022, volume=38, issue=8, pageStart=760, pageEnd=768, url=null, language=null, rfNumber=24, rfOrder=28, authorNames=雷凯, 刘力铭, 熊然, journalName=中华创伤杂志, refType=null, unstructuredReference=雷凯， 刘力铭， 熊然， 等. 全膝关节置换术中智能精准辅助技术的应用及研究进展［J］. 中华创伤杂志， 2022， 38（8）： 760-768., articleTitle=全膝关节置换术中智能精准辅助技术的应用及研究进展, refAbstract=null), Reference(id=1320441249711112922, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.3760/cma.j.cn501098-20220322-00206, pmid=null, pmcid=null, year=2022, volume=38, issue=8, pageStart=760, pageEnd=768, url=null, language=null, rfNumber=24, rfOrder=29, authorNames=LEI K, LIU L M, XIONG R, journalName=Chin J Trauma, refType=null, unstructuredReference=LEI K， LIU L M， XIONG R， et al. Application and research progress of intelligent accuracy technological aids in total knee arthroplasty［J］. Chin J Trauma， 2022， 38（8）： 760-768., articleTitle=Application and research progress of intelligent accuracy technological aids in total knee arthroplasty, refAbstract=null), Reference(id=1320441250101183195, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1002/rcs.2300, pmid=null, pmcid=null, year=2021, volume=17, issue=5, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=25, rfOrder=30, authorNames=LI Z, ZHANG X F, DING L L, journalName=Int J Med Robot, refType=null, unstructuredReference=LI Z， ZHANG X F， DING L L， et al. Deep learning approach for guiding three-dimensional computed tomography reconstruction of lower limbs for robotically-assisted total knee arthroplasty［J］. Int J Med Robot， 2021， 17（5）： e2300., articleTitle=Deep learning approach for guiding three-dimensional computed tomography reconstruction of lower limbs for robotically-assisted total knee arthroplasty, refAbstract=null), Reference(id=1320441250470281948, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, doi=10.1177/15563316251339596, pmid=null, pmcid=null, year=2025, volume=null, issue=null, pageStart=15563316251339596, pageEnd=null, url=null, language=null, rfNumber=26, rfOrder=31, authorNames=OETTL F C, ZSIDAI B, OEDING J F, journalName=HSS J, refType=null, unstructuredReference=OETTL F C， ZSIDAI B， OEDING J F， et al. Artificial intelligence and musculoskeletal surgical applications［J］. HSS J， 2025： 15563316251339596., articleTitle=Artificial intelligence and musculoskeletal surgical applications, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1320441221139513963, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, xref=1, ext=[AuthorCompanyExt(id=1320441221156291180, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, companyId=1320441221139513963, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Sports Medicine Center， First Affiliated Hospital， Army Medical University （Third Military Medical University）， Chongqing), AuthorCompanyExt(id=1320441221164679789, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, companyId=1320441221139513963, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1陆军军医大学（第三军医大学）第一附属医院运动医学中心)]), AuthorCompany(id=1320441222024512110, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, xref=2, ext=[AuthorCompanyExt(id=1320441222037095023, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, companyId=1320441222024512110, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Department of Orthopedics， Jiangbei Branch of First Affiliated Hospital （No. 958 Hospital of Chinese PLA）， Army Medical University （Third Military Medical University）， Chongqing， China), AuthorCompanyExt(id=1320441222045483632, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, companyId=1320441222024512110, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2陆军军医大学第一附属医院江北院区骨科，重庆)])], figs=[ArticleFig(id=1320441233248469654, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=EN, label=Figure 1, caption=Schematic diagram of the study workflow, figureFileSmall=6uWylBcJ2a6pun+FuwxETQ==, figureFileBig=xvFabNtzSl/syNURC7wpAA==, tableContent=null), ArticleFig(id=1320441233315578519, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=CN, label=图1, caption=研究流程示意图, figureFileSmall=6uWylBcJ2a6pun+FuwxETQ==, figureFileBig=xvFabNtzSl/syNURC7wpAA==, tableContent=null), ArticleFig(id=1320441234087330456, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=EN, label=Figure 2, caption=Example of conventional planning report for total knee arthroplasty （TKA）, figureFileSmall=Sob9e22OLV/ou+LPwgGjIA==, figureFileBig=RSYzPKc8J48uSKjVkGWq6Q==, tableContent=null), ArticleFig(id=1320441235072991898, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=CN, label=图2, caption=传统规划报告示例, figureFileSmall=Sob9e22OLV/ou+LPwgGjIA==, figureFileBig=RSYzPKc8J48uSKjVkGWq6Q==, tableContent=null), ArticleFig(id=1320441235152683675, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=EN, label=Figure 3, caption=Example of AI planning report total knee arthroplasty （TKA）, figureFileSmall=tS1uG6w6OGxPtjdRrgPpFw==, figureFileBig=2wM4bZdWiiycFt3ibMBJfw==, tableContent=null), ArticleFig(id=1320441235370787484, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=CN, label=图3, caption=AI规划报告示例, figureFileSmall=tS1uG6w6OGxPtjdRrgPpFw==, figureFileBig=2wM4bZdWiiycFt3ibMBJfw==, tableContent=null), ArticleFig(id=1320441235442090653, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=EN, label=Figure 4, caption=Lower limb anatomical parameters measured on X-ray films before and after surgery, figureFileSmall=3WK9clNDpgx0L6B7kWZP/g==, figureFileBig=Q8OedNls4tL6EESrB0OB7Q==, tableContent=null), ArticleFig(id=1320441235836355230, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=CN, label=图4, caption=术前术后在X线平片上测量的下肢解剖参数

HKS： Distal femoral osteotomy angle， the angle between the femoral mechanical axis and the distal femoral anatomical axis； mLDFA： Mechanical lateral distal femoral angle， the lateral angle between the femoral mechanical axis and the tangent of the distal femoral articular surface； MPTA： Mechanical medial proximal tibial angle， the medial angle between the tibial mechanical axis and the tangent of the proximal tibial articular surface； HKA： Angle between the femoral mechanical axis and the tibial mechanical axis； FFC： Lateral angle between the femoral mechanical axis and the tangent of the distal articular surface of the femoral prosthesis； FTC： Medial angle between the tibial mechanical axis and the tangent of the proximal articular surface of the tibial prosthesis

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AI-Conv.： comparison between AI planning and conventional planning

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AI-IO： Comparison between AI planning and actual intraoperative data； Conv.-IO： Comparison between conventional planning and actual intraoperative data

, figureFileSmall=dNBGLIHbArKJ2XVt3U6Z7Q==, figureFileBig=UP1VGeXEfFltalzMhByivA==, tableContent=null), ArticleFig(id=1320441237098840739, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=EN, label=Table 1, caption=

Baseline characteristics and anatomical parameters of the patients before surgery

, figureFileSmall=null, figureFileBig=null, tableContent=
Items≤60 years group （n=22）>60 years group （n=105）P
Baseline characteristics
Male∶Female4∶1827∶78n.s.
Age/years54.3±4.570.7±4.6<0.05
Left∶Right10∶1246∶59n.s.
BMI/（kg/m2）27.5±3.325.9±3.1n.s.
Anatomical parameters
HKA （°）6.6±8.111.0±8.5<0.05
HKS （°）5.6±1.37.0±1.8<0.05
mLDFA （°）88.1±2.789.0±3.8n.s.
MPTA （°）87.0±2.684.2±3.5<0.05
), ArticleFig(id=1320441237526659748, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=CN, label=表1, caption=

患者术前基本信息及解剖参数

, figureFileSmall=null, figureFileBig=null, tableContent=
Items≤60 years group （n=22）>60 years group （n=105）P
Baseline characteristics
Male∶Female4∶1827∶78n.s.
Age/years54.3±4.570.7±4.6<0.05
Left∶Right10∶1246∶59n.s.
BMI/（kg/m2）27.5±3.325.9±3.1n.s.
Anatomical parameters
HKA （°）6.6±8.111.0±8.5<0.05
HKS （°）5.6±1.37.0±1.8<0.05
mLDFA （°）88.1±2.789.0±3.8n.s.
MPTA （°）87.0±2.684.2±3.5<0.05
), ArticleFig(id=1320441237858009765, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=EN, label=Table 2, caption=

Comparison of indicator differences between AI planning and conventional planning， and comparison of their differences with actual intraoperative data

, figureFileSmall=null, figureFileBig=null, tableContent=
ItemsAI-planConv.-planPAI-IOConv.-IOP
HKS （°）7.1±2.16.3±1.6<0.051.7±1.51.0±0.9<0.05
Femoral resection difference/mm2.3±1.81.3±2.0<0.051.5±2.30.5±2.0<0.05
Tibial resection difference/mm-4.0±2.3-4.6±2.1<0.050.7±3.20.1±2.9<0.05
Femoral rotation angle （°）1.7±3.41.3±0.8n.s.-1.9±3.6-2.3±1.6n.s.
), ArticleFig(id=1320441237946090151, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=CN, label=表2, caption=

AI规划与传统规划的指标差异对比及二者与术中真实数据的差值对比

, figureFileSmall=null, figureFileBig=null, tableContent=
ItemsAI-planConv.-planPAI-IOConv.-IOP
HKS （°）7.1±2.16.3±1.6<0.051.7±1.51.0±0.9<0.05
Femoral resection difference/mm2.3±1.81.3±2.0<0.051.5±2.30.5±2.0<0.05
Tibial resection difference/mm-4.0±2.3-4.6±2.1<0.050.7±3.20.1±2.9<0.05
Femoral rotation angle （°）1.7±3.41.3±0.8n.s.-1.9±3.6-2.3±1.6n.s.
), ArticleFig(id=1320441238013199017, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=EN, label=Table 3, caption=

Comparison of differences between AI planning and conventional planning in different age groups

, figureFileSmall=null, figureFileBig=null, tableContent=
Items≤60 years group （n=22）>60 years group （n=105）
AI-planConv.-planPAI-planConv.-planP
HKS （°）5.8±1.35.7±1.0n.s.7.3±2.16.5±1.6<0.05
Femoral resection difference/mm2.6±2.01.8±1.7<0.052.2±1.81.1±2.0<0.05
Tibial resection difference/mm-3.5±2.2-4.0±1.7n.s.-4.1±2.3-4.7±2.2<0.05
Femoral rotation angle （°）0.3±5.81.3±0.7n.s.2.0±2.51.3±0.8<0.05
), ArticleFig(id=1320441238281634474, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=CN, label=表3, caption=

不同年龄组AI规划与传统规划差异对比

, figureFileSmall=null, figureFileBig=null, tableContent=
Items≤60 years group （n=22）>60 years group （n=105）
AI-planConv.-planPAI-planConv.-planP
HKS （°）5.8±1.35.7±1.0n.s.7.3±2.16.5±1.6<0.05
Femoral resection difference/mm2.6±2.01.8±1.7<0.052.2±1.81.1±2.0<0.05
Tibial resection difference/mm-3.5±2.2-4.0±1.7n.s.-4.1±2.3-4.7±2.2<0.05
Femoral rotation angle （°）0.3±5.81.3±0.7n.s.2.0±2.51.3±0.8<0.05
), ArticleFig(id=1320441238378103467, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=EN, label=Table 4, caption=

Comparison of differences between AI planning， conventional planning and actual intraoperative data in different age groups

, figureFileSmall=null, figureFileBig=null, tableContent=
Items≤60 years group （n=22）>60 years group （n=105）
AI-IOConv.-IOPAI-IOConv.-IOP
HKS （°）0.9±1.30.8±1.1n.s.1.9±1.51.0±0.9<0.05
Femoral osteotomy difference （mm）1.4±3.10.7±2.8<0.051.4±2.10.4±1.8<0.05
Tibial osteotomy difference （mm）1.2±3.40.7±3.2n.s.0.6±3.10.0±2.9<0.05
Femoral rotation angle （°）-3.7±6.2-2.7±1.9n.s.-1.5±2.7-2.2±1.6<0.05
), ArticleFig(id=1320441240387175085, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=CN, label=表4, caption=

不同年龄组AI规划和传统规划与术中真实数据的差值对比

, figureFileSmall=null, figureFileBig=null, tableContent=
Items≤60 years group （n=22）>60 years group （n=105）
AI-IOConv.-IOPAI-IOConv.-IOP
HKS （°）0.9±1.30.8±1.1n.s.1.9±1.51.0±0.9<0.05
Femoral osteotomy difference （mm）1.4±3.10.7±2.8<0.051.4±2.10.4±1.8<0.05
Tibial osteotomy difference （mm）1.2±3.40.7±3.2n.s.0.6±3.10.0±2.9<0.05
Femoral rotation angle （°）-3.7±6.2-2.7±1.9n.s.-1.5±2.7-2.2±1.6<0.05
), ArticleFig(id=1320441240479449774, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=EN, label=Table 5, caption=

Postoperative measurement results of patients

, figureFileSmall=null, figureFileBig=null, tableContent=
Items≤60 years group （n=22）>60 years group （n=105）P
HKA （°）0.3±3.52.7±4.0<0.05
FFC （°）90.8±2.691.9±2.8n.s.
FTC （°）89.8±1.789.0±1.7n.s.
), ArticleFig(id=1320441240856937135, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1320441214789337685, language=CN, label=表5, caption=

患者术后测量结果

, figureFileSmall=null, figureFileBig=null, tableContent=
Items≤60 years group （n=22）>60 years group （n=105）P
HKA （°）0.3±3.52.7±4.0<0.05
FFC （°）90.8±2.691.9±2.8n.s.
FTC （°）89.8±1.789.0±1.7n.s.
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人工智能辅助全膝关节置换术前规划在60岁以下患者中的优势表现：一项回顾性横断面对比研究
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曾科 1 , 余尚委 1 , 刘力铭 2 , 郭林 1
陆军军医大学学报 | 智能医学与预测模型 2026,48(6): 822-830
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陆军军医大学学报 |智能医学与预测模型 2026 , 48 (6) : 822 -830
人工智能辅助全膝关节置换术前规划在60岁以下患者中的优势表现：一项回顾性横断面对比研究
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曾科1, 余尚委1, 刘力铭2 , 郭林1
作者信息
  • 1陆军军医大学（第三军医大学）第一附属医院运动医学中心
  • 2陆军军医大学第一附属医院江北院区骨科，重庆
通讯作者:
刘力铭，E-mail：
郭林，E-mail：
LIU Liming，E-mail：
GUO Lin，E-mail：
Superior performance of artificial intelligence-assisted preoperative planning for total knee arthroplasty in patients under 60 years: a retrospective cross-sectional comparative study
Ke ZENG1, Shangwei YU1, Liming LIU2 , Lin GUO1
Affiliations
  • 1Sports Medicine Center， First Affiliated Hospital， Army Medical University （Third Military Medical University）， Chongqing
  • 2Department of Orthopedics， Jiangbei Branch of First Affiliated Hospital （No. 958 Hospital of Chinese PLA）， Army Medical University （Third Military Medical University）， Chongqing， China
出版时间: 2026-03-30 doi: 10.16016/j.2097-0927.202512155
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摘要
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目的

探究人工智能（artificial intelligence， AI）辅助全膝关节置换（total knee arthroplasty， TKA）术前规划的准确性是否不劣于三维工程师和医生合作完成的人工TKA术前规划，并评估年龄对AI规划精准度的影响。

方法

本研究采用回顾性、横断面比较设计，回顾性收集127名在2022年12月至2023年9月于陆军军医大学第一附属医院行TKA的患者资料，根据年龄分为≤60岁组（40-60岁，n=22）和>60岁组（61~80岁，n=105）。对所有患者分别进行AI辅助术前规划（AI规划）与计算机辅助人工术前规划（传统规划）。对比患者AI规划、传统规划及术中真实的股骨远端截骨角（hip-knee-shaft angle， HKS）、股骨截骨差、胫骨截骨差、股骨旋转角和假体型号数据，以及AI规划和传统规划的时间、人力及经济成本。非劣效界值设定为截骨角度差≤1°、截骨厚度差≤1 mm、假体型号差≤1个。

结果

与传统规划相比，AI规划HKS平均偏大（0.8±1.2）°，Cohen’s d =0.4（95%CI：0.2~0.7）；股骨截骨差平均偏大（1.1±1.8） mm，Cohen’s d=0.5（95%CI为0.3~0.8）；胫骨截骨差平均偏大（0.6±1.7）mm，Cohen’s d =0.3（95%CI为0~0.5），以上“标准化平均差异”的95%CI下限均大于其“负的非劣效界值”。与传统规划相比，≤60岁组AI规划在HKS、胫骨截骨差和股骨旋转角无显著差异（P>0.05），>60岁组AI规划仅股骨截骨差的差异超过非劣效性界值（平均偏大1.1 mm，P<0.05）。假体型号预测方面，AI规划有73.2%的股骨假体和87.4%的胫骨假体预测型号差异未超过1个型号，传统规划有81.9%的股骨假体和90.6%的胫骨假体预测型号差异未超过1个型号，二者无显著差异。AI规划耗时显著短于传统规划［（27.4±4.1） min vs. （45.3±8.5） min，P<0.05］，且无需额外人力与设备成本（患者费用为0元/例vs. 3 000元/例）。

结论

TKA的AI术前规划具有不劣于传统规划模式的精准度，尤其在60岁以下患者中表现更优，同时具备显著的时间与经济成本优势。

全膝关节置换术  /  人工智能  /  术前规划  /  精准度  /  下肢对线
Objective

To investigate whether the accuracy of artificial intelligence (AI)-assisted preoperative planning for total knee arthroplasty (TKA) is non-inferior to computer-assisted manual preoperative planning completed collaboratively by 3D engineers and orthopedic surgeons, and to evaluate the impact of age on the accuracy of AI-based planning.

Methods

This study adopted a retrospective, cross-sectional comparative design. Data were retrospectively collected from 127 patients who underwent TKA at the First Affiliated Hospital of Army Medical University between December 2022 and September 2023. They were divided into a ≤60 years group (40 to 60 years old, n=22) and an >60 years group (61 to 80 years old, n=105) based on age. All patients underwent both AI-assisted preoperative planning (AI planning) and computer-assisted manual preoperative planning (conventional planning). Hip-knee-shaft angle (HKS), femoral resection difference, tibial resection difference, femoral rotation angle, and prosthesis size data from AI planning, conventional planning, and actual intraoperative measurements, as well as time, manpower, and economic costs of AI planning and conventional planning were compared between the 2 planning methods. The non-inferiority margin was set as resection angle difference ≤1°, resection thickness difference ≤1 mm, and prosthesis size difference ≤1.

Results

Compared with the conventional planning, the AI planning showed a mean increase of 0.8°±1.2° in HKS (Cohen’s d=0.4, 95%CI: 0.2 to 0.7), a mean increase of 1.1±1.8 mm in femoral resection difference (Cohen’s d=0.5, 95%CI: 0.3 to 0.8), and a mean increase of 0.6±1.7 mm in tibial resection difference (Cohen’s d=0.3, 95%CI: 0.0 to 0.5). The lower limits of 95%CI for these above standardized mean differences were all greater than their corresponding negative non-inferiority margins. In comparison with the conventional planning, the AI planning in the ≤60 years group showed no significant differences in HKS, tibial resection difference, and femoral rotation angle (P>0.05), whereas in the >60 years group, only femoral resection difference of AI planning exceeded the non-inferiority margin (with a mean increase of 1.1 mm, P<0.05). For prosthesis size prediction, the AI planning achieved 73.2% femoral prosthesis and 87.4% tibial prosthesis predictions with size differences not exceeding 1, while conventional planning achieved 81.9% femoral prosthesis and 90.6% tibial prosthesis predictions with size differences not exceeding 1, with no significant difference between the 2 planning methods (P>0.05). The time consumed for AI planning was significantly shorter than that for conventional planning (27.4±4.1 vs 45.3±8.5 min, P<0.05). Moreover, AI planning required no additional labor and equipment costs, with no additional manpower or equipment costs (0 vs 3 000 Yuan/case).

Conclusion

AI-assisted preoperative planning for TKA s demonstrates non-inferior accuracy compared with conventional planning, with superior performance particularly in patients under 60 years, and significant advantages in time and economic costs.

total knee arthroplasty  /  artificial intelligence  /  preoperative planning  /  accuracy  /  lower limb alignment
曾科, 余尚委, 刘力铭, 郭林. 人工智能辅助全膝关节置换术前规划在60岁以下患者中的优势表现：一项回顾性横断面对比研究. 陆军军医大学学报, 2026 , 48 (6) : 822 -830 . DOI: 10.16016/j.2097-0927.202512155
Ke ZENG, Shangwei YU, Liming LIU, Lin GUO. Superior performance of artificial intelligence-assisted preoperative planning for total knee arthroplasty in patients under 60 years: a retrospective cross-sectional comparative study[J]. Journal of Army Medical University, 2026 , 48 (6) : 822 -830 . DOI: 10.16016/j.2097-0927.202512155
正文
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全膝关节置换术（total knee arthroplasty， TKA）是目前治疗膝关节毁损伤病的主要手段，通过人工假体替代毁损的关节表面并纠正异常力线，从而缓解疼痛、改善功能、提高生活质量［1］。准确的截骨、假体安装和下肢对线是TKA手术成功的关键因素，精准的术前规划有助于提高其准确度，进而提高假体生存率及患者满意率［1-3］。机器人和计算机导航方法被认为可以提高手术准确度，但因其术中注册更加耗时［4］、较长的学习曲线及更加高昂的成本，使得这些技术无法普及［5］。研究表明，使用基于CT的个性化三维术前规划结合传统手术工具亦可以提高手术精准度，但这种方法需要三维工程师和医生合作完成，且完成一套术前规划大约需要半个小时以上，使得该方法未能广泛使用［6］。
近年来，AI技术的高效性、智能化和自主学习特点被越来越多地应用于膝骨关节炎（knee osteoarthritis， KOA）诊断和TKA规划。利用深度学习技术对X线、CT和MRI影像数据进行分析，可用于评估KOA程度并预测病情进展并可以辅助术前规划［7-8］。研究表明，使用AI辅助TKA术前规划可以显著降低术前规划的时间和人力成本，适合在各层级医院推广并且不会增加额外医疗花费［9］。随着年龄增高，股骨外侧弓状畸形加重，可能导致股骨远端截骨角（hip-knee-shaft angle， HKS）增大及下肢内翻畸形加重［10］，然而这种变化在60岁以上人群中更加明显［11］，但其对TKA术前规划精准度的影响尚不清楚。且目前尚无AI辅助TKA术前规划软件的临床准确性和有效性研究。本研究采用回顾性、横断面比较设计，旨在：①探讨AI辅助TKA术前规划方式的准确性是否不劣于由三维工程师和医生合作完成人工TKA术前规划，且具备智能、便捷、经济等优势；②评估年龄对AI规划准确度的影响。
1　资料与方法
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1.1　患者临床资料与分组
本研究回顾性收集2022年12月至2023年9月于陆军军医大学第一附属医院行TKA的患者资料共127例。纳入标准为：①患者年龄40~80岁；②诊断为单侧膝关节重度骨性关节炎（K-L Ⅳ期）；③曾行全下肢CT扫描者。排除标准为：①伴有重度髋关节或踝关节骨性关节炎；②既往存在下肢骨折、畸形或先天性异常等；③曾有患侧膝关节手术史；④曾接受同侧髋关节或踝关节置换手术治疗；⑤曾接受改变下肢力线的其他手术治疗。最终共收集了127例患者资料，其中男性31例，女性96例，左侧56例，右侧71例，平均年龄（67.9±7.8）岁，平均BMI （26.2±3.2） kg/m2。本研究方案获陆军军医大学第一附属医院伦理委员会批准（KY2022145）。本研究将纳入的受试者根据年龄进行分层，年龄40~60岁为≤60岁组，年龄61~80岁为>60岁组。两组工作人员分别为每一位患者行术前规划方式，即AI辅助术前规划组（以下简称AI规划组）与计算机辅助人工术前规划组（以下简称传统规划组）。
1.2　AI及传统术前规划方法
AI规划组由陆军军医大学第一附属医院运动医学中心2位住院医师组成，二者均接受了软件操作培训，且AI规划完全自主，其规划结果不会因操作人员变更而改变。传统规划组由1位高年资膝关节置换手术医师与2位软件工程师组成，两组人员独立完成每位患者术前规划（具体流程可见图1）。
1.2.1　传统规划
收集患者的全下肢CT扫描影像数据（1 mm层厚）并使用Mimics Research 19.0进行3D重建。借助CATIA 5.20和NX12.0软件，根据LEI等［4］的研究所述方法由计算机软件工程师和外科医生制定了针对TKA患者的3D术前规划（图2）。
1.2.2　AI规划
采用AIKnee（全膝关节置换术智能三维建模及关键轴线识别系统，V1.0）软件进行术前规划。该软件自动对患者下肢CT进行分割以及三维重建，采用深度学习方法，使用U-Net模型对三维图像进行分割和重建，V-Net模型对股骨、胫骨的解剖学标志点进行标记。AI规划组工作人员将患者下肢全长CT数据压缩成zip文件，随后将文件上传至云端计算机，计算机通过自动对CT数据进行三维重建，得到股骨、胫骨解剖点并分别生成stl及txt文件，下载上述得到的文件导入到AIKnee软件，得到TKA术前截骨数据（图3）。
1.2.3　解剖标记
进行股骨头的最佳球形拟合，其中心点与股骨髁间切迹顶点之间的线定义为股骨的机械轴。连接膝关节线上方10 cm和20 cm的股骨髓腔中心点的线被定义为股骨远端的解剖轴。股骨外上髁最突出的点与股骨内侧上髁最凹陷的点之间的线是外科通髁轴（surgical transepicondylar axis，sTEA）。由股骨机械轴和sTEA定义的平面记录为冠状面，垂直于股骨机械轴的平面记录为横断面。在胫骨结节下方5 cm和踝关节踝穴上方5 cm处连接胫骨髓腔中心点的线定义为胫骨机械轴。
1.2.4　两种术前规划的截骨数据
①股骨生理外翻角在冠状面上的投影角度，记为股骨远端截骨角（HKS）；②sTEA与股骨后髁切线在横断面上的投影夹角，记录为股骨旋转角；③股骨远端内、外髁的截骨量；④胫骨近端内、外侧平台的截骨量；⑤股骨、胫骨预估使用的假体型号大小。
1.3　全膝关节置换术中操作
手术采用椎管内麻醉联合神经阻滞麻醉。患者取仰卧位，常规消毒铺单后使用无菌止血带止血，采用髌旁内侧入路完成显露。部分清除膝关节软组织和增生的骨赘后，从髁间窝顶点位置打入股骨髓内导向杆，参照传统规划角度进行股骨远端截骨。选取合适的四合一截骨导板进行股骨四合一截骨和髁间截骨。完成胫骨脱位后，将胫骨髓外定位杆远端对准第二趾，近端对准胫骨结节中内1/3处，评估后倾角后，参考外侧平台行9 mm截骨。彻底去除相关软组织后，平衡屈伸间隙。如发现对线不良，可使用pie-crusting、调整截骨或后方松解等方式松解周围软组织以实现软组织平衡。装上假体试模并测试稳定性后，用骨水泥固定假体，安装聚乙烯衬垫后再次测试屈伸间隙，解除止血带。彻底冲洗关节腔，关闭切口，适当加压包扎。全部患者的手术均由本院同一名高级外科医生进行，术者选择传统规划作为术中参考并结合患者术中实际情况进行截骨策略调整，全部患者均使用微创公司膝关节假体，由助手记录术中真实截骨数据（同术前规划数据）。
1.4　术前及术后下肢解剖参数影像学测量方法
所有患者术前及术后（出院前）均进行了患侧前后站立负重位下肢全长X光片复查，将影像导入AutoCAD（Version 2019）后，测量患者术前股骨机械轴与胫骨机械轴之间的夹角（hip-knee-ankle angle， HKA）、HKS、股骨机械轴与股骨远端关节面切线的外侧夹角（mechanical lateral distal femoral angle， mLDFA）、胫骨机械轴与胫骨近端关节面切线的内侧夹角（medial proximal tibial angle， MPTA），测量患者术后HKA、股骨机械轴与股骨假体远端关节面切线的外侧夹角为冠状面股骨假体角（frontal femoral component angle， FFC）、胫骨机械轴与胫骨假体近端关节面切线的内侧夹角为冠状面胫骨假体角（frontal tibial component angle， FTC）。全部数据由3名经验丰富的关节外科医师独立盲测2次，测量间期大于2周（图4）。
1.5　观测指标
（1）AI规划、传统规划及术中实际观测指标：①HKS；②股骨旋转角；③股骨截骨差：即股骨远端内髁截骨厚度减去外髁截骨厚度之差；④胫骨截骨差：即胫骨近端内侧平台截骨厚度减去外侧平台截骨厚度之差；⑤股骨、胫骨预估使用的假体型号大小。
（2）术前及术后影像学观测指标：①HKA；②HKS；③mLDFA；④MPTA；⑤FFC；⑥FTC。
（3）正负值定义标准：HKA（胫骨机械轴相对于股骨机械轴）内翻记为正值，外翻记为负值，股骨旋转角（股骨后髁线相对于sTEA）外旋记为正值，内旋记为负值。
（4）非劣效性界值标准：
研究表型，TKA术中由于摆锯摆动和股骨髓内导向杆位置造成的偏差约0.9~1.1°［12-13］，HKS发生1°的偏差，会导致1 mm的截骨偏差［14］。故而，本研究的非劣效性界值标准定义为：截骨角度差值不超过1°，内外侧截骨厚度差异的差值不超过1 mm，假体型号差异不超过1个型号且与术中实际使用假体尺寸≤3 mm［15-17］。
1.6　统计学方法
所有数据采用SPSS 25.0进行分析。计量资料采用x¯±s表示，采用Shapiro-Wilk方法对数据进行正态性检验。符合正态分布的数据，AI规划与传统规划对比或AI规划与术中真实差异与传统规划与术中真实差异对比，采用配对样本t检验进行组间统计学比较；>60岁组与≤60岁组对比，采用独立t检验进行组间统计学比较。非正态分布的数据AI规划与传统规划对比或AI规划与术中真实差异与传统规划与术中真实差异对比，采用两个相关样本Wilcoxon检验进行组间统计学比较；>60岁组与≤60岁组对比，采用两个独立样本Wilcoxon检验进行组间统计学比较。计数资料采用比例或百分比表示，并使用卡方检验进行评估。进行非劣效性对比时，计算两组变量的“标准化平均差异（Cohen’s d）”及其95%CI，判断其95%CI下限是否大于“负的非劣效界值”（为了统一尺度，将对以上非劣效界值进行标准化后再进行对比）。双侧检验P<0.05表示差异有统计学意义。
2　结果
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2.1　患者基本情况及术前测量结果
本研究共计纳入127例患者，其中≤60岁组22例，>60岁组105例。与≤60岁组相比，>60岁组拥有更大的HKA、HKS以及更小的MPTA（表1）。
2.2　AI规划与传统规划的观察指标及二者与术中真实数据的偏差值存在统计学差异，但未超过非劣效性界值
与传统规划相比，AI规划HKS平均偏大0.8±1.2°，Cohen’s d=0.4（95%CI：0.2~0.7），标准化非劣效界值为0.5；股骨截骨差平均偏大（1.1±1.8）mm，Cohen’s d=0.5（95%CI：0.3~0.8），标准化非劣效界值为0.5；胫骨截骨差平均偏大（0.6±1.7）mm，Cohen’s d=0.3（95%CI：0~0.5），标准化非劣效界值为0.5（表2），以上“标准化平均差异”的95%CI下限均大于其“负的非劣效界值”。股骨旋转角平均偏大（0.3±3.4）°。AI规划与传统规划有59.1%的股骨假体和44.9%的胫骨假体预测型号相同，有30.7%的股骨假体和49.6%的胫骨假体预测相差1个型号（图5）。AI规划平均用时（27.4±4.1）min，传统规划平均用时（45.3±8.5） min（P<0.05）。目前，临床上完成一份传统规划报告患者需支付3 000元左右的费用。
术中实际平均HKS为（5.4±1.5）°、股骨截骨差为（0.8±2.2）mm、胫骨截骨差（-4.7±3.3）mm、股骨旋转角为（3.6±1.6）°。与AI规划相比，传统规划在HKS、股骨截骨差和与胫骨截骨差方面术中实际更为接近，而两种规划的股骨旋转角与术中实际差异均达到2°以上（表2）。与术中实际相比，AI规划有73.2%的股骨假体和87.4%的胫骨假体预测型号差异未超过1个型号，传统规划有81.9%的股骨假体和90.6%的胫骨假体预测型号差异未超过1个型号（P>0.05，图6）。
2.3　AI规划和传统规划在60岁以下患者中无显著差异
在≤60岁组人群中，AI规划和传统规划较为相似，仅股骨截骨差平均差0.8 mm；但在>60岁组人群中，AI规划的股骨截骨差平均偏大1.1 mm，HKS平均偏大0.9°，胫骨截骨差平均偏大0.7 mm，股骨旋转角平均偏大0.6°（表3）。与术中真实数据相比，>60岁组传统规划在HKS、股骨截骨差和与胫骨截骨差方面与术中实际更为接近，其中股骨截骨差的差值超过非劣效性界值（表4）。
2.4　>60岁组患者术后下肢力线更加内翻
与≤60岁组相比，>60岁组术后下肢更加内翻（表5）。
3　讨论
收起
本研究最主要的发现是TKA术前AI规划在HKS、股骨截骨差、胫骨截骨差和股骨旋转角方面具有不劣于传统规划的精准度，且在60岁以下患者中与传统规划同样精准。此外，AI规划具备显著的时间、人力和经济成本优势。
与传统规划相比，AI规划策略倾向于选择更大的HKS、股骨截骨差和胫骨截骨差，但2组差异均未超过本研究设定的非劣效性界值。区分不同年龄来看，≤60岁组患者的HKS、胫骨截骨差和股骨旋转角在两种规划中无显著差异，仅AI规划的股骨截骨差比传统规划平均偏大0.8°；但在>60岁组患者中，AI规划的HKS、股骨截骨差、胫骨截骨差和股骨旋转角均比传统规划更大，但仅有股骨截骨差超过了本研究设定的非劣效性界值（平均偏大1.1 mm）。FACTOR等［18］利用RSIP XPlan.aiTM技术（RSIP Vision，以色列）和模型自主学习能力，成功建立了AI辅助基于X线的单模态下肢三维模型，但其AI辅助股骨解剖角度测量偏差超过1.7°，精度需进一步提升。北京长木谷公司开发的AI规划系统是目前国内最为完整的商用TKA三维智能术前规划系统［19］。但有研究报道其对术中截骨量及截骨角度的交互设计较少［19］，且其部分下肢解剖角度测量误差超过1.5°［20］。在假体型号预测中，本研究使用的AI规划与传统规划差异不超过1个型号的比例为股骨侧89.8%，胫骨侧94.5%，二者在假体型号预测方面高度相似。
本研究纳入术中真实截骨数据作为参考，用AI规划和传统规划与之相比较，发现由于AI规划策略倾向于更大的HKS、股骨截骨差和胫骨截骨差，导致其与术中真实截骨数据差异更大。进一步区分不同年龄来看，≤60岁组患者两种规划结果相似，但>60岁组患者的AI规划显示出偏大的规划策略，进而导致其HKS、股骨截骨差和胫骨截骨差与术中实际截骨值的差异更大。产生这种差异的原因可能是：①>60岁组患者存在更严重的下肢内翻畸形、股骨外侧弓状畸形和骨赘增生，进而可能导致AI标志点识别偏差［10， 21-22］；②术者术中选择传统规划作为参考，再结合术中实际情况进行调整，进而导致差异增大；③≤60岁组与>60岁组存在显著样本量差异，可能对结果产生影响。与术中实际相比，AI规划和传统规划预测股骨假体差异不超过1个型号的比例为73.2%和81.9%（P>0.05），预测胫骨假体差异不超过1个型号的比例为87.4%和90.6%（P>0.05）。可以看出，两种方式预测胫骨假体的准确率明显高于股骨侧，这与MARCHAND等［23］的研究发现类似，这可能与股骨远端形态相较于胫骨近端更加复杂有关。班吉鹤等［15］使用长木谷的AI规划系统对60例TKA进行研究后指出，指出AI规划与术中差异不超过1个型号的比例在股骨侧有93.3%，在胫骨侧有95%；杜浩源等［16］使用同样的AI规划系统对28例TKA进行对比后指出差异不超过1个型号的比例在股骨侧有85.7%，在胫骨侧有96.4%。二者使用的AI规划拥有更高的假体型号预测精准度，可能是因为他们较小的样本量，且术中严格参考AI规划执行，进而得到更加精准的匹配度。
从术后测量结果来看，>60岁组患者术后残留更大的下肢内翻，而导致内翻的主要原因是术后拥有更大的FFC（平均91.9°），这可能是因为术者在术中选择了更小的HKS导致的（术中实际选择HKS平均5.4°、传统规划HKS平均6.5°、AI规划HKS平均7.4°）。若选择AI规划作为截骨参考，术中HKS角选择平均偏大1.9°，可能会进一步纠正>60岁组患者偏大的FFC，进而改善术后下肢内翻的结果。相比于传统规划，AI规划更倾向于按照下肢力线中立位目标对线进行术前设计。
AI规划相较于传统规划在时间、人力和经济成本上具有独特优势［24］。参与本研究的传统规划工程师均具有10年以上工作经验，尚需要（45.3±8.5）min完成规划，而本研究使用的AI规划软件需通过专属保密通道上传至云端计算机完成，约700 M的CT原始文件上传平均需要超过20 min时间，尽管如此AI规划时间较传统规划平均缩短18 min（27.4±4.1），而在实验室进行单机部署应用时，AI规划可在5 min内完成。LI等［25］的研究使用AI构建下肢三维模型平均用时仅为4.7 min。在人力成本上，传统规划依靠工程师使用计算机软件对患者下肢CT进行三维重建，然后需要在经验丰富的膝关节置换医生的指导下对标志点标记、测量截骨角度、模拟TKA手术、虚拟截骨，随着技术愈加熟练，流程耗时会从平均75 min减少到45 min，但需要工程师有较长的学习曲线［6］。本研究所使用AI规划系统能够自动进行下肢CT三维重建、识别标志点、测量截骨角度并自动完成虚拟截骨和假体匹配，软件的操作流程高度标准化，且针对同一患者的规划不会因操作人员变更而改变，任何人仅需接受简单的软件操作培训即可使用，非常适合在县市级医院推广。在经济成本上，本研究使用的传统规划为第三方公司完成，平均花费约3 000元，而AI规划软件由国家课题资助完成研发，后续使用成本主要是维护成本，广泛使用后边际成本极低，具有显著的经济成本优势。此外，更精准的术前规划能够有效减少手术时间、术中失血量及术后下肢对线不良的发生率，进而减少术后并发症，从而全面降低总体医疗费用［26］。
本研究存在以下局限性：①本研究是一项回顾性研究，通过两种术前规划方式的截骨数据与实际手术中的截骨数据进行比较，术中仍避免不了依靠术者的经验以及手术理念，截骨的准确与否也只是与该术者相关，并没有唯一“金标准”。②本研究未纳入患者术后的功能评分以及满意度等进行对比，仅对比两种术前规划截骨数据的精准度，未来可以通过采用多中心、随机对照试验对两种术前规划进行比较。③本研究使用的AI规划仅针对测量截骨法进行规划建议，尚无法术前将软组织平衡因素纳入考量，后续将会进一步纳入更多的前瞻性术中松解数据和手术前后下肢力线变化数据，进一步训练AI模型以更加接近人类专家的软组织平衡决定。④本研究≤60岁组和>60岁组样本量差异较大，主要源于本院TKA患者年龄分布的自然偏倚，可能会对本研究结论存在潜在影响。
目前针对于使用国产假体进行TKA的患者，AI规划在HKS、股骨截骨差、胫骨截骨差和股骨旋转角方面具有不劣于传统规划的精准度，且其在60岁以下患者中更加精准。随着算法的改进及训练模型样本量提升，AI规划精准度可能会进一步提升。此外，AI规划在时间、人力及经济成本方面的独特优势使其具备广阔应用前景。

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参考文献 引证文献
排序方式：
1
ROBBINS G M， MASRI B A， GARBUZ D S， et al. Preoperative planning to prevent instability in total knee arthroplasty［J］. Orthop Clin North Am， 2001， 32（4）： 611-626， viii.
2
GOYAL N， STULBERG S D. Evaluating the precision of preoperative planning in patient specific instrumentation： can a single MRI yield different preoperative plans？［J］. J Arthroplasty， 2015， 30（7）： 1250-1253.
3
文材， 尹立. 人工膝关节置换术的发展概况与进展［J］. 中国医药指南， 2018， 16（31）： 31-34.
WEN C，YIN L. Development and progress of artificial knee replacement［J］. Guide China Med， 2018， 16（31）： 31-34.
4
LEI K， LIU L M， YANG P F， et al. Robotics versus personalized 3D preoperative planning in total knee arthroplasty： a propensity score-matched analysis［J］. J Orthop Surg Res， 2022， 17（1）： 227.
5
HE R， SUN M L， XIONG R， et al. A newly designed “SkyWalker” robot applied in total knee arthroplasty： a retrospective cohort study for femoral rotational alignment restoration［J］. Orthop Surg， 2022， 14（8）： 1681-1694.
6
刘国彬， 刘森， 王立飞， 等. 一种基于“H”点的全新3D打印个性化截骨导板辅助胫骨高位截骨术的尸体研究［J］. 实用骨科杂志， 2021， 27（10）： 941-946， 950.
LIU G B，LIU S， WANG L F， et al. A novel 3D-printed patient-specific instrument based on “H” point for medial opening-wedge high tibial osteotomy： a cadaver study［J］. J Pract Orthop， 2021， 27（10）： 941-946， 950.
7
VON EISENHART-ROTHE R， HINTERWIMMER F， GRAICHEN H， et al. Artificial intelligence and robotics in TKA surgery： promising options for improved outcomes？［J］. Knee Surg Sports Traumatol Arthrosc， 2022， 30（8）： 2535-2537.
8
SCHWARZ G M， SIMON S， MITTERER J A， et al. Artificial intelligence enables reliable and standardized measurements of implant alignment in long leg radiographs with total knee arthroplasties［J］. Knee Surg Sports Traumatol Arthrosc， 2022， 30（8）： 2538-2547.
9
FERNANDES L R， ARCE C， MARTINHO G， et al. Accuracy， reliability， and repeatability of a novel artificial intelligence algorithm converting two-dimensional radiographs to three-dimensional bone models for total knee arthroplasty［J］. J Arthroplasty， 2023， 38（10）： 2032-2036.
10
LIU L M， LEI K， CHEN X， et al. Proximal external femoral torsion increases lateral femoral shaft bowing： a study based on 3D CT reconstruction models［J］. Knee Surg Phys Traumatol Arthrosc， 2023， 31（4）： 1524-1532.
11
NAKANO N， MATSUMOTO T， HASHIMURA M， et al. Coronal lower limb alignment in normal knees： a radiographic analysis of 797 normal knee subjects［J］. Knee， 2016， 23（2）： 209-213.
12
OTANI T， WHITESIDE L A， WHITE S E. Cutting errors in preparation of femoral components in total knee arthroplasty［J］. J Arthroplasty， 1993， 8（5）： 503-510.
13
HARUTA Y， KAWAHARA S， TSUCHIMOCHI K， et al. Deviation of femoral intramedullary alignment rod influences coronal and sagittal alignment during total knee arthroplasty［J］. Knee， 2018， 25（4）： 644-649.
14
KINZEL V， SCADDAN M， BRADLEY B， et al. Varus/Valgus alignment of the femur in total knee arthroplasty. Can accuracy be improved by pre-operative CT scanning？［J］. Knee， 2004， 11（3）： 197-201.
15
班吉鹤， 李鹏鹏， 彭礼禄， 等. 人工智能模拟技术在全膝关节置换术前规划中的应用［J］. 现代实用医学， 2025， 37（4）： 405-407.
BAN J H， LI P P， PENG L L， et al. Application of artificial intelligence simulation technology in pre-planning of total knee replacement［J］. Mod Pract Med， 2025， 37（4）： 405-407.
16
杜浩源， 陈达伊， 姜嵩， 等. 人工智能三维规划辅助全膝关节置换术的研究［J］. 中文科技期刊数据库（引文版）医药卫生， 2024（1）： 121-126.
DU H Y， CHEN D Y， JIANG S， et al. Study on artificial intelligence 3D planning assisted total knee arthroplasty［J］. Chin Sci J Database（Cit Ed） Med Health， 2024（1）： 121-126.
17
MAHONEY O M， KINSEY T. Overhang of the femoral component in total knee arthroplasty： risk factors and clinical consequences［J］. J Bone Joint Surg Am， 2010， 92（5）： 1115-1121.
18
FACTOR S， GUREL R， DAN D， et al. Validating a novel 2D to 3D knee reconstruction method on preoperative total knee arthroplasty patient anatomies［J］. J Clin Med， 2024， 13（5）： 1255.
19
吴东， 刘星宇， 张逸凌， 等. 人工智能辅助全髋关节置换术三维规划系统的研发及临床应用研究［J］. 中国修复重建外科杂志， 2020， 34（9）： 1077-1084.
WU D， LIU X Y， ZHANG Y L， et al. Research and application of artificial intelligence based three-dimensional preoperative planning system for total hip arthroplasty［J］. Chin J Reparative Reconstr Surg， 2020， 34（9）： 1077-1084.
20
LI S L， LIU X Y， CHEN X， et al. Development and validation of an artificial intelligence preoperative planning and patient-specific instrumentation system for total knee arthroplasty［J］. Bioengineering， 2023， 10（12）： 1417.
21
LIU L M， LEI K， CHEN X， et al. Is Valgus cut angle based on radiographic measurements in total knee arthroplasty really inaccurate？ a comparison of two- and three-dimensional measurements［J］. J Knee Surg， 2022， 35（14）： 1563-1570.
22
LIU L M， LEI K， GUO L， et al. Surgical transepicondylar axis is not a reliable reference when there was lateral femoral bowing［J］. Orthop Surg， 2022， 14（12）： 3209-3215.
23
MARCHAND R C， SODHI N， BHOWMIK-STOKER M， et al. Does the robotic arm and preoperative CT planning help with 3D intraoperative total knee arthroplasty planning？［J］. J Knee Surg， 2019， 32（8）： 742-749.
24
雷凯， 刘力铭， 熊然， 等. 全膝关节置换术中智能精准辅助技术的应用及研究进展［J］. 中华创伤杂志， 2022， 38（8）： 760-768.
LEI K， LIU L M， XIONG R， et al. Application and research progress of intelligent accuracy technological aids in total knee arthroplasty［J］. Chin J Trauma， 2022， 38（8）： 760-768.
25
LI Z， ZHANG X F， DING L L， et al. Deep learning approach for guiding three-dimensional computed tomography reconstruction of lower limbs for robotically-assisted total knee arthroplasty［J］. Int J Med Robot， 2021， 17（5）： e2300.
26
OETTL F C， ZSIDAI B， OEDING J F， et al. Artificial intelligence and musculoskeletal surgical applications［J］. HSS J， 2025： 15563316251339596.
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doi: 10.16016/j.2097-0927.202512155
  • 接收时间：2025-12-29
  • 首发时间：2026-10-23
  • 出版时间：2026-03-30
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  • 收稿日期：2025-12-29
  • 修回日期：2026-02-01
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    1陆军军医大学（第三军医大学）第一附属医院运动医学中心
    2陆军军医大学第一附属医院江北院区骨科，重庆

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