上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

计算机辅助下全膝关节置换术对恢复下肢机械轴线的准确性研究

徐 军, 姜雪峰, 孙惠清, 杨惠光, 沈建国   

  1. 东南大学附属江阴市人民医院骨一科， 江阴 214400
  • 出版日期:2014-12-28 发布日期:2014-12-30
  • 通讯作者: 姜雪峰, 电子信箱: 328807751@qq.com。
  • 作者简介:徐 军（ 1977—），男， 主治医师; 电子信箱: xj6520@sina.com。

Study on accuracy of computer assisted total knee arthroplasty for restoration of lower-extremity mechanical axis

XU Jun, JIANG Xue-feng, SUN Hui-qing, YANG Hui-guang, SHEN Jian-guo   

  1. Department of Orthopedic， People's Hospital of Jiangyin City， Southeast University, Jiangyin 214400，China
  • Online:2014-12-28 Published:2014-12-30

PDF (PC)

1049

摘要：

目的 比较计算机辅助方法和传统定位方法在进行全膝关节置换术（TKA）时对恢复下肢机械轴线的准确性。方法 选取2012年1月—2013年6月中行TKA的40例患者进行前瞻性研究。随机分为传统手术组和导航手术组，每组20例。传统手术组中男性7例，女性13例，平均年龄为（62.4±6.9）岁，采用传统的标准TKA；导航手术组中男性9例，女性11例，平均年龄为（63.6±8.7）岁，采用计算机辅助TKA。两组患者采用同一品牌关节假体，所有病例均为同一医师完成手术。比较两组患者手术时间、术后24 h引流量、术后1个月和6个月的HSS评分和膝关节屈曲活动度、下肢机械轴线角度。结果 导航手术组的手术时间较传统手术组长（t=3.273，P=0.019），但术后24 h引流量比传统手术组少（t=2.156，P=0.031）；术后1个月的HSS评分和膝关节活动度，导航手术组比传统手术组更高（大）；以上差异均有统计学意义（P<0.05）。术后6个月的HSS评分差异无统计学意义（P>0.05），导航手术组的膝关节活动度较传统手术组大（t=1.232，P=0.047）。导航手术组术后恢复的下肢机械轴线角度（0.87°±0.92°）较传统手术组（1.93°±1.37°）更接近于0°，差异有统计学意义（t=2.756，P=0.025）；而两组手术假体和下肢机械轴的夹角比较，显示差异无统计学意义（P>0.05）。结论 计算机辅助下的TKA对下肢机械轴线的恢复较传统手术更加精确。

关键词: 计算机辅助, 膝关节置换, 下肢机械轴线, 手术

Abstract:

Objective To compare the accuracy of computer assisted total knee arthroplasty (TKA) and conventional positioning TKA for restoration of lower-extremity mechanical axis. Methods A prospective study for 40 patients who underwent TKA from January 2012 to June 2013 was conducted. Patients were randomly divided into the conventional surgery (CS) group (n=20) and the navigation surgery (NS) group (n=20). For the CS group, there were 7 male patients and 13 female patients with average age of (62.4±6.9) years and the conventional positioning TKA was adopted. For the NS group, there were 9 male patients and 11 female patients with average age of (63.6±8.7) years and the computer assisted TKA was adopted. Patients of both groups used the same brand of joint prostheses and all surgeries were performed by the same surgeon. The operation time, 24-hour drainage volume, the HSS scores 1 month and 6 months after the surgery, knee flexion, and lowerextremity mechanical axis angle of two groups were compared. Results The average operation time of the NS group was longer than that of the CS group (t=3.273, P=0.019), but 24-hour drainage volume of NS group was less than that of the CS group (t=2.156, P=0.031). The HSS scores and the average knee flexion of the NS group 1 month after the surgery were higher than those of the CS group and the differences were statistically significant (P<0.05). The differences of the HSS scores of the two groups 6 months after the surgery were not statistically significant (P>0.05). The average knee flexion of the NS group was larger than that of the CS group (t=1.232, P=0.047). The postoperative lower-extremity mechanical axis angle of the NS group (0.87°±0.92°) was closer to 0° than that of the CS group (1.93°±1.37°) and the difference was statistically significant (t=2.756, P=0.025). The difference of the angle between joint prosthesis and lower-extremity mechanical axis of two groups was not statistically significant (P>0.05). Conclusion The computer assisted TKA is more accurate than the conventional positioning TKA for the restoration of lower-extremity mechanical axis.

Key words: computer assisted, total knee arthroplasty, lower-extremity mechanical axis, surgery