数字化导航技术在人工全膝关节置换中的初步应用研究

Preliminary Application of Digital Navigation Technology in Total Knee Replacement

目的:探讨数字化导航技术在人工全膝关节置换术中应用的可行性及初步临床应用。方法:对我院2013年6月至2014年6月行单侧全膝关节置换术的80例患者,按照抽签法随机分为数字化导航组40例及传统手术组40例,导航组术前设计个性化定制导航模板,术中应用导航模板截骨,传统组应用厂家器械截骨。分别测量两组患者手术前后的髋-膝-踝角、冠状面股骨和胫骨截骨面与机械轴夹角、矢状面股骨和胫骨截骨面与外旋和后倾夹角,记录每一例患者手术时间及术中出血量并进行对比。结果:数字化导航组患者的手术时间及术中出血量均少于传统手术组,差异具有统计学意义(P<0.05)。与传统手术组比较,数字化导航组术后冠状面FFC角及FTC角平均偏差角度较小,差异具有统计学意义(P<0.05)。与传统手术组比较,数字化导航组术后矢状面LFC角及LTC角平均偏差角度较小,差异具有统计学意义(P<0.05)。结论:数字化导航技术在人工膝关节置换术中具有快速、个性化及精确性高等优点,值得临床推广应用。

Objective： To study the effect of digital navigation technology on the total knee arthroplasty and the feasibility of the preliminary clinical application. Methods： 80 patients with unilateral total knee replacement who were treated in our hospital from June2013 to June 2014 were selected and randomly divided into the digital navigation group and the traditional surgical group with 40 cases in each group. The digital navigation group were treated with preoperative design personalized custom navigation template and intraoperative navigation template applied bone cutting, while the traditional surgical group were treated with manufacturer bone cutting instrument. Then the HKA angle, the FFC horn, FTC, sagittal alignment LFC angle and LTC angle in the two groups were measured and the operation time and intraoperative blood loss in the two groups were observed and compared. Results： The operation time and blood loss in the digital navigation group were lower than those of the traditional surgical group, and the differences were statistically significant（P〈0.05）; Compared with the traditional surgical group after operation, the coronal FFC angle and the FTC angle deviation in the digital navigation group were less than those of the traditional surgical group, and the differences were statistically significant（P〈0.05）; Compared with the traditional surgical group after operation, The sagittal LFC angle and LTC angle deviation in the digital navigation group were less than those of the traditional surgical group, and the differences were statistically significant（P〈0.05）. Conclusion： The digital navigation technology in artificial knee joint replacement is fast, personalized and higher accuracy, which is worthy of clinical promotion.