计算机导航辅助与传统初次人工全膝关节置换术的早期疗效比较  

Comparison of early effect between computer-navigated and conventional primary total knee arthroplasty

作　　者：赵平 程加峰 耿家金 杨民 张永强 张强 汪洋 鲁斌 ZHAO Ping;CHENG Jiafeng;GENG Jiajin;YANG Min;ZHANG Yongqiang;ZHANG Qiang;WANG Yang;LU Bin(Department of Orthopedics,Wuhu No.1 People′s Hospital,Wuhu 241000,China)

机构地区：[1]芜湖市第一人民医院骨一科,安徽芜湖241000

出　　处：《皖南医学院学报》2023年第3期243-246,共4页Journal of Wannan Medical College

基　　金：芜湖市卫生健康委员会科研和技术项目(芜卫科教[2019]5号)。

摘　　要：目的:比较计算机导航辅助与传统初次人工全膝关节置换术(TKA)的早期临床疗效,探讨计算机导航辅助TKA手术优势。方法:选取芜湖市第一人民医院骨一科2019年6月~2021年6月60例(60膝)初次行TKA的膝关节骨性关节炎患者为研究对象,根据术中是否使用计算机导航分为导航组(30例,30膝)和非导航组(30例,30膝)。比较两组的手术时间、切口长度、总出血量、术后引流量、术后下肢力线髋膝踝角(HKA)偏移、术后膝关节美国特种外科医院(HSS)评分、西安大略和麦克马斯特骨关节炎指数(WOMAC)评分及术后并发症等。结果:导航组手术时间[(84.33±4.87)min]较非导航组[(74.03±6.23)min]长(P<0.001)。导航组手术切口长度[(13.14±0.64)cm]较非导航组[(12.09±0.75)cm]长(P<0.001)。导航组术后引流量[(68.53±10.70)mL]较非导航组[(77.57±12.11)mL]少(P<0.01)。导航组术后HKA偏移角度[(1.33±088)°]小于非导航组[(2.87±1.17)°](P<0.001)。导航组术后各时间段膝关节HSS、WOMAC评分均优于非导航组(P<0.05)。两组患者术后手术并发症总体发生率差异无统计学意义(P>0.05)。结论:计算机导航辅助TKA能提高下肢力线的精准度,提高膝关节假体安放的准确性,近期临床效果优于传统手术。但计算机导航相对增加了切口长度,延长了手术时间。Objective:To compare the early effect of computer-navigated and conventional primary total knee arthroplasty(TKA)and investigate the advantages of using computer navigation in TKA.Methods:Sixty patients with knee osteoarthritis(60 knees)underwent primary TKA between June 2019 and June 2021 in Wuhu No.1 People′s Hospital were included,and divided into the navigation group(n=30;30 knees)and non-navigation group(n=30;30 knees).The two groups were compared pertinent to operative time,incision length,total blood loss,postoperative drainage volume,lower extremity alignment(hip-knee-ankle,HKA angle),Hospital for Special Surgery(HSS)score and Western Ontario and McMaster Osteoarthritis Index(WOMAC)score of the knee as well as postoperative complications.Results:The operative time and the incision length were longer and greater in the navigation group than in the non-navigation group[(84.33±4.87)min vs.(74.03±6.23)min;(13.14±0.64)cm vs.(12.09±0.75)cm,respectively,both P<0.001],yet the postoperative drainage volume and HKA angle were less and smaller in the navigation group than in the non-navigation group[(68.53±10.70)mL vs.(77.57±12.11)mL;(1.33±088)°vs.(2.87±1.17)°,respectively,both P<0.001].Both HSS and WOMAC scores were superior in the navigation group to those in the non-navigation group at each time period after operation(P<0.005),whereas there was no significant difference in the incidence of postoperative complications between groups(P>0.05).Conclusion:Computer navigated TKA can improve the accuracy of lower extremity alignment correction and knee prosthesis placement,and its early effect is better than that of the conventional surgery.However,computer navigation may inevitably result in added incision length and operative time.

关 键 词：计算机导航 膝关节骨性关节炎 全膝关节置换术 下肢力线 

分 类 号：R687.4[医药卫生—骨科学]