计算机导航辅助全膝关节表面置换术治疗膝节骨关节炎  

Computer-assisted navigation total knee arthroplasty for treatment of knee osteoarthritis

作　　者：马元琛[1] 廖俊星[1] 林子洪[1] 李梦远[1] 郑秋坚[1] 

机构地区：[1]广东省医学科学院,广东省人民医院骨科,广州510080

出　　处：《中华创伤骨科杂志》2014年第7期599-602,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的 探讨计算机导航辅助全膝关节表面置换术治疗膝关节骨关节炎的临床疗效. 方法 回顾性分析2012年5月至12月收治且获随访的38例膝关节骨关节炎患者资料,根据治疗方式不同分为2组：导航组18例,男2例,女16例;原发性骨关节炎13例,创伤性骨关节炎5例;术中应用计算机导航系统进行定位截骨,行全膝关节表面置换术;对照组20例,男1例,女19例;原发性骨关节炎18例,创伤性骨关节炎2例;应用传统的手术器械定位截骨,行全膝关节表面置换术.比较两组患者的手术时间、术后1年美国膝关节协会评分（KSS）、X线片上的下肢轴线和假体位置. 结果 38例患者术后获平均15.8个月（12 ～ 18个月）随访.导航组患者的手术时间[（101.9±10.1）mm]较对照组[（79.5 ±5.0）min]长,胫骨后倾角度（0.5°±0.6°）较对照组（1.6°±1.0°）小,差异均有统计学意义（P＜0.05）,而两组患者术后1年KSS评分、机械轴夹角、股骨角度及胫骨角度之间比较差异均无统计学意义（P＞0.05）.导航组和对照组患者术后机械轴夹角位于±3°的百分率分别为88.9％（16/18）和70.0％（14/20）,差异无统计学意义（P＞0.05）.两组患者随访期间均无浅部或深部感染、下肢深静脉血栓形成、髌骨或假体周围骨折、假体松动或下沉等并发症发生. 结论 计算机导航辅助全膝关节表面置换术能够获得与传统全膝关节表面置换术相同的临床疗效,且假体安放角度较传统手术更精确.Objective To investigate the clinical outcomes of computer-assisted navigation total knee arthroplasty （TKA） for the treatment of knee osteoarthritis.Methods From May to December 2012,38 patients with knee osteoarthritis （OA） were treated with TKA.Computer-assisted navigation was used in 18 of them （2 men and 16 women） with 13 cases of primary OA and 5 ones of traumatic OA.Conventional TKA was conducted in the other 20 patients （one man and 19 women） with 18 cases of primary OA and 2 ones of traumatic OA.The 2 groups were compared in terms of operation time,American Knee Society score （KSS） one year postoperation,mechanical axis of the lower limb and prosthesis alignment on X-ray films.Results The patients were followed up for an average of 15.8 month （from 12 to 18 months）.Compared with the conventional group,the navigation group had significantly longer operation time （101.9 ± 10.1 min versus 79.5 ± 5.0 min）,a significantly smaller tibial slope angle （0.5°± 0.6° versus 1.6°± 1.0°）（P ＜ 0.05）.There were no significant differences between the 2 groups regarding KSS score,included angle of the mechanical axis,femoral angle or tibia angle （P ＞ 0.05）.88.9％ （16/18） of the patients in the navigation group and 70.0％ （14/20） of those in the conventional group had an included angle of the mechanical axis of ± 3°,showing no significant difference either （P ＞ 0.05）.No infection,lower limb deep venous thrombosis,patellar or peri-prosthetic fracture,prosthetic loosening or collapse was observed in either group.Conclusion Compared with conventional TKA,computer-assisted navigation TKA may achieve similar clinical outcomes but more precise placement of the prosthesis.

关 键 词：外科手术 计算机辅助 关节成形术 置换 膝 骨关节炎 

分 类 号：R687.4[医药卫生—骨科学]