iASSIST智能辅助定位系统在人工全膝关节置换术中的应用

Clinical Application of i ASSIST Navigation System Assisted Total Knee Arthroplasty in the Treatment of Osteoarthritis

目的:探讨i ASSIST辅助定位系统在人工膝关节表面置换(TKA)术中应用的准确性及有效性。方法:2016年4至6月行TKA手术40例,随机分为2组,其中实验组20例(A组)采用i ASSIST辅助TKA手术,对照组20例(B组)采用常规TKA手术。测量并比较两组的冠状面髋-膝-踝(hip knee ankle,HKA)角、冠状面股骨组件角(frontal femoral component,FFC)角、冠状面胫骨组件(frontal tibial component,FTC)角、矢状面股骨组件屈曲(lateral femoral flexion,LFF)角、矢状面胫骨组件(lateral tibial component,LTC)角的偏移值;记录两组的手术时间、术中出血量、术后引流量、术后并发症发生率,术后满意度以及术后1天、1周、2周、1月、3月的VAS与KSS评分,并进行比较。结果:A组术后偏差值的HKA、FFC、FTC、LFF、LTC均小于B组。手术时间A组长于B组,术后引流量、术后并发症发生率两组比较无显著性差异。A组在术后的患者满意度调查结果优于B组,术后1天、1周、2周、1月的VAS评分两组无显著性差异,术后2周1月的KSS评分A组优于B组(P<0.05),术后3月无显著性差异。结论:i ASSIST膝关节辅助定位系统可以实现TKA手术精确的术中截骨定位,可以帮助提高TKA的手术联系,其远期结果值得进一步随访。

Objective: To investigate the application of iASSIST Knee system assisted total knee arthroplasty (TKA) in the treatment of osteoarthritis (OA). Methods: Twenty consecutive patientswith osteoarthritis (OA) who were treated with the iASSIST Knee System assisted method between April 2016 to June 2016 (Group A). Meanwhile, twenty consecutive patients with OA treated with conventional intramedullary method were treated (Group B). All patients were taken X-ray images of full length of lower limbs. The coronal and sagittal alignment, blood loss and drainage at one week postoperatively and the range of motion at one week, 6 weeks and 3 months were evaluated. Results: The average difference-value of HKA, FFC, LFF, FTC and LTC at Group A were lower than Group B. Group A have a smaller amount of post-operative wound drainage, compared to the intramedullary procedure (P<0.05).Group B has a lower KSS score at 2 weeks, 1 month postoperative, compared to Group A. Conclusion: The iASSIST may help to make TKA procedure more accurately and rapidly with extramedullary positioning, which may be useful for the improvement of clinical effects.