导航辅助全膝置换治疗膝关节骨性强直的临床初探

Computer-assisted navigation for total knee arthroplasty:a comparative study with conventional methods

目的总结计算机导航定位与常规定位手术在膝关节表面置换术治疗膝关节骨性强直两组病例的疗效差异。方法对比计算机导航定位与常规定位人丁膝关节表面置换术后两组病例的力线、软组织平衡、并发脂肪栓塞、出血量、手术时间进行统计学处理。结果全部病例随访5～12个月,平均9个月,导航组11膝力线检测数据误差明显小于常规定位组11膝,导航组软组织平衡数据的角度变量、距离变量都明显小于常规定位组。两组都未发生脂肪栓塞。结论计算机导航技术用于膝关节骨性强直膝表面置换,使假体植入的更精确,软组织平衡更佳,与常规组有显著差异。但延长了手术时间。

Objective To compare the effects of Computer-assisted navigation （CAS） and conventional location technique in total knee arthroplasty （TKA）. Methods Eight patients （ 11 knees） underwent CAS and 9 patients （ 11 knees） underwent conventional location technique for TKA. Follow-up was conducted for 5-12 months. The outcomes were compared. Results The mechanical axe error of the CAS group was （ 2. 14 ± 0. 25 ） °, significantly less than that of the conventional group [ （ 5.12 ± 2. 13 ）°, P =0. 005 ]. The soft tissue balance angle variable of the CAS group was （ 1.04 ±0. 18） °, significantly less than that of the conventional group [ （4. 12 ± 1.72） ° ,P =0. 005 ]. The soft tissue separation variable of the CAS group was （3.4 ± 1.2） mm, significantly less than that of the conventional group [ （6. 1 ± 2. 4） mm, P =0. 005]. No fat embolism occurred in these 2 groups. The operating time of the CAS group was （82 ± 18） rain, significantly longer than that of the conventional group [ （59 ± 11 ） min, P = 0. 005 ]. Conclusion CAS causes more reliable artificial joint implantation and better soft-tissues balance, however, needs more operating time.