计算机导航系统辅助全膝关节置换术治疗膝关节骨性关节炎的早期疗效

Early effects of computer navigation system assisted total knee arthroplasty for treatment of knee osteoarthritis

目的探讨计算机导航系统辅助全膝关节置换术(TKA)治疗膝关节骨性关节炎(OA)的早期疗效。方法将40例膝关节OA患者根据治疗方法不同分成导航组(采用计算机导航系统辅助TKA治疗,20例)和传统组(采用传统TKA治疗,20例)。比较两组手术时间、术中出血量、术后引流量以及术后膝关节活动度,测量冠状面髋-膝-踝角(HKA)、冠状面股骨组件角(FFC)、冠状面胫骨组件角(FTC)、矢状面股骨组件角(LFC)、矢状面胫骨组件角(LTC),比较两组冠状面和矢状面的假体位置偏差角度。结果患者均获得随访,时间3~12个月。导航组手术时间长于传统组,术中出血量、术后引流量少于传统组,差异均有统计学意义(P<0.01)。膝关节活动度术后1周导航组大于传统组(P<0.01),术后2周、3个月两组比较差异均无统计学意义(P>0.05)。术后3个月HKA、FFC、FTC、LFC、LTC偏差值导航组均小于传统组(P<0.05)。结论计算机导航系统能提高TKA下肢机械轴和假体安装的准确性,减少术中出血,但延长了手术时间,短期对关节活动度的改善没有明显的优势,远期结果需进一步随访。

Objective To investigage the early effect of computer navigation system assisted total knee arthroplasty(TKA)in the treatment of knee osteoarthritis(KOA).Methods According to different treatment methods,40 patients with KOA were divided into navigation group(using compute navigation system assisted TKA,20 cases)and conventional group(using conventional TKA,20 cases).The operation time,intraoperative blood loss volume,postoperative drainage volume,and postoperative range of motion of the knee joint were compared between the two groups.The following data were measured,including the coronal hip-knee-ankle angle(HKA),frontal femoral component angle(FFC),frontal tibial component angle(FTC),lateral femoral component angle(LFC),lateral tibial component angle(LTC),the prosthesis position deviation angles of the coronal and sagittal planes were compared between the two groups.Results All patients were followed up for 3~12 months.The operation time of the navigation group was longer than that of the conventional group,and the intraoperative blood loss volume and postoperative drainage volume were less than those of the conventional group.The differences were statistically significant(P<0.01).The ROM of the knee joint in the navigation group was bigger than that of the conventional group at 1 week after operation(P<0.01),and there were no significant differences between the two groups at 2 weeks and 3 months after operation(P>0.05).The deviation values of HKA,FFC,FTC,LFC,LTC in the navigation group were smaller than those in the conventional group at 3 months after operation(P<0.05).Conclusions The computer navigation system can improve the accuracy of lower limb mechanical axis and prosthesis installation in TKA,reduce intraoperative bleeding volume,but prolong the operation time,and there is no obvious advantage in the improvement of joint mobility in the short term,the long-term results require further follow-up.