计算机导航下解剖标志异常的膝关节置换术  

Arthroplasty of the knees with anatomical abnormality under navigation-assisted system

作　　者：吴毛[1] 顾晓峰[1] 许宏俊[1] 程力[1] 

机构地区：[1]无锡市人民医院骨科,214023

出　　处：《中华创伤杂志》2010年第11期977-981,共5页Chinese Journal of Trauma

摘　　要：目的 探讨在计算机导航下骨解剖异常的全膝关节置换术（total knee arthroplasty,TKA）的疗效及其优越性.方法 2007年12月-2008年10月共对5例骨解剖异常的膝关节行TKA（导航组）,手术均在计算机导航辅助下进行.随机选取既往未使用计算机导航的5例行TKA患者作为非导航组,均具有正常解剖标志.术后3 d常规摄正、侧位X线片,分别测量α、β、γδ角及关节活动度.结果 术中、术后未发生因导航而出现的并发症.两组α、β、γ及δ角虽然差异无统计学意义,但导航组的极值范围很小,其取得极值的可能性远远小于非导航组.术后导航组膝关节活动范围平均为112.67°,非导航组为106.98°,但两组术前活动范围[导航组（70.87±10.78）°,非导航组（105.08±30.67）°]比较,差异有统计学意义.结论 计算机导航下TRA的近期疗效与机械定位相比无明显优势,但在力线上均明显较机械定位精确.计算机导航下TKA特别对于解剖异常的膝关节,可降低手术难度,提高手术精度.Objective To discuss the effect and advantage of the navigation-assisted system in total knee arthroplasty （TKA） of the knees with anatomical abnormality. Methods The study involved five patients with anatomical abnormality of the knees who were treated with arthroplasty under the navigation-assisted system from December 2007 to October 2008. Meanwhile, five patients with normal anatomy of the knees treated with total knee arthroplasty without using the navigation-assisted system were used as control. The α, β, γand δ angles were measured based on the X-ray images and the active range of the knee joint was determined. Results No complication caused by navigation occurred. There was no significant difference in the α, β, γ and δ angles between the two groups, but the range of extremum in the navigation group was less than that of the control group. The mean postoperative active range of the knee joint in the navigation group （ 112.67°） was higher than that of the control group （ 106.98° ）, while the preoperative active range of the knee joint of the navigation group [（70.87 ± 10.87）°] was significantly lower than that of the control group [（ 105.08 ± 30.67）°]. Conclusions Compared with conventional methods, navigation-assisted TKA showas no obvious advantage in short-term outcome but has great advantages in improving the accuracy and the joint movement, especially for the knees with anatomical abnormality.

关 键 词：关节成形术 置换 膝 外科手术 计算机辅助 解剖异常 

分 类 号：R686[医药卫生—骨科学]