计算机辅助个体化导航模板在全膝关节置换术中的研究

Research on computer aided individual navigatio n templates in total knee arthroplasty

目的:通过临床应用评价个体化导航模板计算机辅助结合快速成形技术在全膝关节置换术(TKA)中获得下肢力线和假体位置的准确性和安全性。方法:将拟实施TKA的膝关节骨性关节炎(Qsteoathritis,OA)患者106例按照数字表法随机分成两组,导航组53例和传统组53例,并比较两组的效果。结果:导航组的失血量明显少于传统组(P<0.05),两组术后膝关节KSS评分差异均较术前改善(均P<0.05),两组手术前后KSS评分差异均无统计学意义(均P>0.05),两组膝关节功能评分均较术前提高(均P<0.05),术后1年两组膝关节功能评分差异无统计学意义(均P>0.05),两组术后1年Feller髌骨评分均较术前改善(均P<0.05),术后两组Feller髌骨评分差异无统计学意义(P<0.05)。结论:计算机辅助导航与传统TKA手术相比较,假体植入更准确,下肢力线更佳,能明显减轻患者术后疼痛和改善功能,早期疗效满意。计算机辅助导航能够为TKA股骨头假体精确定位、定向提供一种新的方法和有效的辅助手段。

Objective To the evaluation of clinical application of individualized Computer Aided navigation template （ Computer Aided Design） combined with rapid prototyping technology （RapidPrototyping,RP） in total knee arthroplasty （TKA） in lower extremity force line and the accuracy and security of the prosthesis position. Method 106 cases of orthopedic intended to implement TKA patients with knee oste- oarthritis （OA Qsteoathritis） ,they were randomly divided into two groups according to the digital meter method,navigation group of 53 cases and traditional surgical group 53 cases ,and the effect of the two groups was fompared. Results Blood loss of navigation group was obviously less than the traditional group （P 〈 0. 05）, two groups of postoperative knee KSS score was better than preoperative （ all P 〈 0. 05 ）, two groups of KSS score before and after operation had no statistical significance （P 〉 0. 05 ）, two groups of knee joint function score was better than pre- operative （all P 〈 0. 05 ）, postoperative 1 year two sets of knee joint function score difference had no statistical significance （ all P 〉 0. 05 ）, two groups of postoperative 1 year Mr. Feller patellar score was better than preoperative （ all P 〈 0. 05 ）, postoperative navigation Feller patellar score improvement was superior to the traditional group （P 〈 0. 05 ）. Conclusion Computer aided navigation compared with conventional TKA surgery, prosthesis implantation more accurate, better lower limb power line, can significantly reduce postoperative pain and improve function, early curative effect is satisfied. Computer aided navigation to TKA femoral head prosthesis precise positioning and orientation provides a new method and effective means of anxiliary.