人工全膝关节置换术中智能关节内应力测量系统与传统软组织平衡评估方法的比较研究  

Comparisons between smart intra-articular force sensing and traditional evaluation techniques for soft-tissue balancing of total knee arthroplasty

作　　者：唐浩[1] 郭盛杰[1] 陈虹[2] 杨德金[1] 蒋毅[1] 张春雨[1] 周一新[1] 

机构地区：[1]北京积水潭医院矫形骨科,北京100035 [2]清华大学微电子研究所

出　　处：《骨科临床与研究杂志》2016年第1期28-33,38,共7页Journal Of Clinical Orthopedics And Research

基　　金：首都临床特色应用研究项目(Z151100004015145)~~

摘　　要：目的探索新型智能应力测量系统与传统软组织平衡评估方法的相关性。方法采用一种新型的应力分布电子测量系统,在50例全膝关节置换术(TKA)中实时测量不同屈曲角度下关节内应力分布的变化,同时应用传统间隙测量和内外翻应力试验方法进行软组织平衡的评估。采用秩相关分析方法分别分析内外侧应力差值与内外侧关节间隙宽度差值以及内外翻应力试验差值间的相关关系。结果膝关节在屈曲0°及90°位,内外侧应力分布差值与内外侧关节间隙测量差值的相关系数r_1=-0.727;在屈曲0°,30°,45°,60°,90°位,内外侧应力分布差值与内外翻应力试验差值的相关系数r_2=-0.671。结论关节内应力分布电子测量系统所测得的应力分布与传统软组织平衡的衡量方法相关性较好,并具有较后者更精确和测量状态更接近TKA术后膝关节真实生物力学环境等优势。Objective To explore the correlation between intra-articular sensing findings of a smart trial system and traditional soft-tissue balancing techniques in total knee arthroplasty （TKA）. Methods We recorded the intraoperative intra-articular force distributions of 50 TKAs （45 patients） with the knee at 5 different flexion angles （0°,30°,45° ,60° and 90°） using the Wireless Force Measurement System （WFMS）. Traditional methods, including gap measurement and varus/valgus stress test, were also used to evaluate the soft tissue balancing. Spearman rank correlation analysis was used to evaluate the correlation between results of force sens- ing and traditional measurements. Results Correlation coefficient between intra-articular force sensing results and gap measurement results at 0° and 90° flexion was -0.727, and the correlation coefficient between intra- articular force sensing results and varus/valgus stress test results at 0°, 30°,45° ,60° and 90° flexion was -0.671. Conclusion The intra-articular sensing technique is moderately correlated with traditional evaluation methods for TKA soft-tissue balancing, and the new method is more precise, and more approximate to the real postoperative biomechanical environment of the knee joints.

关 键 词：关节成形术 置换 膝 生物力学 关节内应力测量 间隙测量法 内外翻应力试验法 

分 类 号：R687.4[医药卫生—骨科学]