计算机导航间隙平衡技术对全膝关节置换术后患者下肢恢复的影响

Effect of computer navigation gap balance technology on lower limb recovery after total knee arthroplasty

目的:探讨计算机导航间隙平衡技术对全膝关节置换术患者术后下肢功能恢复的影响。方法:回顾性分析2018年7月至2019年6月接受全膝关节置换术的106例膝关节骨性关节炎(osteoarthritis,OA)患者的临床资料,根据全膝关节置换术中截骨技术不同分为测量截骨组和间隙平衡组。测量截骨组61例,男24例,女37例;年龄45~77(63.35±4.26)岁;K-L分级,Ⅲ级41例,Ⅳ级20例,术中实施测量截骨技术。间隙平衡组45例,男17例,女28例;年龄45~78(64.03±4.31)岁;K-L分级,Ⅲ级29例,Ⅳ级16例,实施计算机导航间隙平衡技术。比较两组患者术中出血量、手术时间、切口长度、住院时间及术后并发症情况,分别于术前、术后12个月采用膝关节协会评分(Knee Society Knee Score,KSS)评价其临床疗效。结果:106例患者均获得随访,时间12~18(20.38±3.25)个月。两组术中出血量、手术时间分比较差异有统计学意义(P<0.05)。两组切口长度和住院时间比较差异无统计学意义(P>0.05)。术后12个月,间隙平衡组KSS总分(173.59±14.50)分优于测量截骨组(164.95±12.10)分(P<0.05)。两组患者随访期间未发生假体松动不良严重并发症,其他并发症发生率组间比较差异无统计学意义(P>0.05)。结论:全膝关节置换术中应用计算机导航间隙平衡技术利于OA患者术后下肢功能恢复,且术后未发生严重不良并发症,安全性高。

Objective:To investigate the effect of computer navigation gap balance technology on the recovery of lower limb function after total knee arthroplasty.Methods:The clinical data of 106 patients with knee osteoarthritis(OA)who underwent total knee arthroplasty from July 2018 to June 2019 were analyzed retrospectively.They were divided into measurement osteotomy group and space balance group according to different osteotomy techniques during total knee arthroplasty.There were 61 cases in osteotomy group,24 males and 37 females;The age ranged from 45 to 77(63.35±4.26)years;According to K-L classification,41 cases were gradeⅢand 20 cases were gradeⅣ.intraoperative measurement osteotomy was performed.There were 45 cases in the gap balance group,17 males and 28 females;Age 45 to 78(64.03±4.31)years;According to K-L classification,29 cases were classified as gradeⅢand 16 cases as gradeⅣ.computer navigation gap balance technology was implemented.The amount of intraoperative bleeding,operation time,incision length,hospital stay and postoperative complications were compared between two groups.The clinical efficacy was evaluated by Knee Society score(KSS)before operation and 12 months after operation.Results:Total of 106 patients were followed up for 12 to 18(20.38±3.25)months.There were significant differences in intraoperative bleeding and operation time between two groups(P<0.05).There was no significant difference in incision length and hospital stay between the two groups(P>0.05).At 12 months after operation,the total score of KSS in the gap balance group(173.59±14.50)was better than that in the osteotomy group(164.95±12.10)(P<0.05).There were no serious complications of poor prosthesis loosening between two groups during follow-up,and there was no significant difference in the incidence of other complications between two groups(P>0.05).Conclusion:The application of computer navigation gap balance technology in total knee arthroplasty is conducive to the recovery of lower limb function in patients with OA,and there are no serious adverse complications and high safety.