电子压力测量垫片在膝关节手术教学中的应用

Application of electrical sensor in total knee arthroplasty training

目的膝关节软组织平衡是关节置换手术成功的关键,以往判断软组织平衡根据术者对韧带张力的感觉,没有精确统一标准,造成教学困难。电子压力测量垫片可以显示内外侧压力数值,可能作为软组织平衡教学的新工具。方法5位进修医生各自参加14例电子压力测量垫片手术,共70例,术中先根据医生的经验完成软组织平衡,再用电子垫片检验膝关节在0°、45°、90°是否平衡。根据时间顺序把病例分成7组,每组10例,统计不平衡病例数,分析经过学习后的效果。结果0°、45°、90°在第1组中不平衡病例分别是7、6、5例,通过学习不平衡病例减少,学习结束后第7组不平衡病例数分别是1、1、2例,0°、45°第1组和第7组比较有显著差异。其中45°不平衡病例数最多,平衡最困难。结论电子压力测量垫片可以作为膝关节软组织平衡教学的工具,通过学习可以快速掌握软组织平衡的判断方法。

Objective Soft tissue balancing in knee joint is a key technique for successful operation of total knee arthroplasty(TKA).There is not a widely accepted metric for balance,manual balance has been achieved primarily through tactile feedback and visual cue.That makes difficulties in learners'training.A new electronic sensor can measure the pressure of medial and lateral compartment of knee,and is applied in the skill training of total knee arthroplasty.Methods Five trainee surgeons attended 14 electronic sensor balancing TKA separately,there are 70 cases in total.Trainee surgeons did manual balance,then it was checked by electronic sensor in 0°,45°,90°knee position.All cases were divided into 7 groups according to chronological order.The unbalance cases were recorded in each group and compared statistically.Results For 0°,45°,90°knee position,the first group has 7,6,5 unbalance cases respectively.During the training,the unbalance case number is decreasing,the seventh group has 1,1,2 unbalance cases at last.There is significant difference between the first and the seventh group for 0°,45°.It is demanding for 45°balancing with most unbalance cases.Conclusions Electronic sensor is a new tool for TKA training.It helps the trainee surgeons to master soft tissue balancing technique quickly and effectively.