红外线计算机导航与传统人工全膝关节置换的相关性研究

INFRARED COMPUTER NAVIGATION AND CONVENTIONAL TOTAL KNEE REPLACEMENT

目的:通过分析计算机导航辅助下人工全膝关节置换手术的初步临床结果,与传统手术进行疗效差异的比较,探讨计算机导航辅助手术的安全性、可靠性及其优势与不足。方法:自2010年至今行计算机辅助人工全膝关节置换术32例32膝(导航组);自2000年至今用传统手术治疗的满足配对条件的病人中随机抽取40例62膝(机械组),全部94膝均为初次置换,两组病人的原始疾病、年龄、HSS评分行配对t检验,差异无统计学意义(P>0.05)。对比两组术后X线资料、软组织平衡、术后引流量、手术时间、并发症等进行统计学处理。结果:髋膝踝经线(mFTA)、软组织平衡角度变量、软组织平衡分离变量、术后24h引流量及手术时间统计学分析显示以上几项指标比较均有统计学意义(P<0.05)。术后两组假体位置角度的比较上α、β、γ、δ及Q角,差异无统计学意义(P>0.05),但在导航组的分布更类似于标准正态分布;取值较为集中,极值范围小。结论:红外计算机导航辅助下全膝关节置换具有出血少、不干扰股骨髓腔、下肢功能恢复快等优点,同时能够恢复下肢的机械轴线,假体位置安装更为准确,软组织平衡更佳,避免了髌-股关节并发症,早期疗效满意。

Objective：To analyze the preliminary clinical results between CAS and routine NCAS localization in TKA and to evaluate the safety and reliability of CAS in order to take advantages and avoid disadvantages of this new technology. Methods： From 2010 untill now,32 cases （32 joints） of TKA in Group Ⅰ , from 2000 untill now, 40 cases （62 joints） of TKA in Group Ⅱ , the differences between to groups in clinical results, X - ray films were - check - postoperative, soft - tissues blance, bloodloss, coincidence and operation time were statistically analyzed. Results：The machnical femoral axis to tibial axis angle,the soft-tissues balance angle, the distance variable, the 24 hours blood loss, the opration time, there were statistically significant differences between two groups. All cases anter-oposterior and lateral projection X-ray films of all involved cases, we compared α and β angles at an-teroposterior films. γ, δ and Q angles lateral films of all involved cases. Although there were no significant differences exisiting between two groups, CAS more similar to be normal distribution, centered value and tiny range. Conclusion： Infrared ray computer navigation assisted total knee replacement promised no femoral medullar disturbance, quick recovery of lower extremity function and reduced blood loss as well as improved the overall post-operatively alignment, component position, soft tissues balance and more idea frontal laxity on initial clinical outcome.