iASSIST-TKA术与PSI-TKA术治疗膝关节骨关节炎的效果及安全性  

Effects and safety of iASSIST navigation system assisted total knee arthroplasty and 3D printed personal specific instrument assisted total knee arthroplasty in the treatment of knee osteoarthritis

作　　者：张超[1] 周迎锋[1] 路坦[1] 赵红星[1] 耿晓林[1] 陶金刚[1] 徐海斌[1] ZHANG Chao;ZHOU Ying-feng;LU Tan;ZHAO Hong-xing;GENG Xiao-lin;TAO Jin-gang;XU Hai-bin(Ward 1 Department of Orthopedic Surgery,the First Affiliated Hospital of Xinxiang Medical College,Weihui 453100,Henan,CHINA)

机构地区：[1]新乡医学院第一附属医院骨外科一病区,河南卫辉453100

出　　处：《海南医学》2022年第11期1406-1410,共5页Hainan Medical Journal

基　　金：河南省高等学校重点科研项目(编号:19A320003)。

摘　　要：目的比较iASSIST便携式导航人工全膝关节置换(iASSIST-TKA)术与3D打印个性化膝关节导板辅助人工全膝关节置换(PSI-TKA)术治疗膝关节骨关节炎(OA)的效果及安全性。方法将新乡医学院第一附属医院骨外科一病区2018年1~12月收治的75例OA患者按非随机临床同期对照研究及患者自愿原则分为iASSIST-TKA组(n=37)和PSI-TKA组(n=38),分别采用iASSIST-TKA术和PSI-TKA术治疗。比较两组患者的手术效果及并发症发生情况。结果iASSIST-TKA组患者的手术时间为(101.47±17.35)min,明显长于PSI-TKA组的(81.25±12.64)min,术后引流量为(213.46±38.14)mL,明显多于PSI-TKA组的(184.27±39.38)m L,住院时间为(6.39±1.66)d,明显短于PSI-TKA组的(7.50±1.27)d,矢状面胫骨组件(LTC)角偏移度为(1.12±0.24)°,明显低于PSI-TKA的(1.25±0.22)°,差异均有统计学意义(P<0.05);术后6个月时,两组患者的美国膝关节协会评分(KSS)临床评分、功能评分和美国特种外科医院(HSS)评分比较差异均无统计学意义(P>0.05);两组患者围术期未见下肢深静脉血栓事件发生,仅iASSIST-TKA组术后1例切口感染,对症处理后治愈。结论iASSIST-TKA术、PSI-TKA术用于膝关节骨关节的临床治疗均安全有效,iASSIST-TKA术住院时间更短,术后LTC偏移度更低,PSI-TKA术则具更短的手术时间及更低的术后引流量。Objective To compare the effects and safety of iASSIST navigation system assisted total knee arthroplasty(iASSIST-TKA)and 3D printed personal specific instrument assisted TKA(PSI-TKA)in the treatment of knee osteoarthritis(OA).Methods Seventy-five patients with OA admitted to Ward 1,Department of Orthopedic Surgery,the First Affiliated Hospital of Xinxiang Medical College from January to December 2018 were divided into iASSIST-TKA group(n=37)and PSI-TKA group(n=38)according to the principle of non-randomized clinical concurrent controlled study and voluntariness.Surgical effects and the incidence of complications were compared between the two groups.Results The operation time of iASSIST-TKA group was(101.47±17.35)min,which was significantly longer than(81.25±12.64)min of PSI-TKA group;the postoperative drainage volume was(213.46±38.14)mL,significantly more than(184.27±39.38)mL of PSI-TKA group;the length of hospital stay was(6.39±1.66)d,significantly shorter than(7.50±1.27)d of PSI-TKA group;and the angular deflection of lateral tibia component(LTC)was(1.12±0.24)°,significantly smaller than(1.25±0.22)°of PSI-TKA;the differences were statistically significant(P<0.05).At 6 months after surgery,there was no statistically significant difference in the American Knee Society Score(KSS),KSS function score or hospital for special surgery(HSS)score between the two groups(P>0.05).No lower extremity deep venous thrombosis was observed in the two groups during the perioperative period.There was 1 patient with postoperative incision infection in iASSIST-TKA group,who was cured after symptomatic treatment.Conclusion Both iASSIST-TKA and PSI-TKA are safe and effective in clinical treatment of knee OA.Patients treated with iASSIST-TKA have shorter length of hospital stay and smaller angular deflection of LTC.However,PSI-TKA results in shorter operation time and lower postoperative drainage.

关 键 词：膝关节骨关节炎 全膝关节置换术 三维打印个性化膝关节导板 便携式导航截骨系统 安全性 

分 类 号：R684.3[医药卫生—骨科学]