OrthoPilot导航辅助胫骨高位截骨术治疗内侧间室膝骨关节炎的中期疗效  

Mid-term outcomes of OrthoPilot navigation-assisted high tibial osteotomy for medial compartment knee osteoarthritis

作　　者：王熠军 郑恺 张连方[1] 朱锋[1] 张韦成 徐耀增[1] 周军 WANG Yijun;ZHENG Kai;ZHANG Lianfang;ZHU Feng;ZHANG Weicheng;XU Yaozeng;ZHOU Jun(Department of Orthopaedics,the First Affiliated Hospital of Soochow University,Suzhou 215000,Jiangsu,China;Department of Orthopaedics,the First Affiliated Hospital of Xiamen University,Xiamen 361000,Fujian,China)

机构地区：[1]苏州大学附属第一医院骨科,江苏苏州215000 [2]厦门大学附属第一医院骨科,福建厦门361000

出　　处：《中华骨与关节外科杂志》2025年第3期222-230,共9页Chinese Journal of Bone and Joint Surgery

基　　金：国家自然科学基金(82072498);苏州市临床重点病种诊疗技术专项(LCZX202302)。

摘　　要：目的:探讨OrthoPilot导航辅助内侧开放楔形胫骨高位截骨术(OWHTO)治疗内侧间室膝骨关节炎的中期疗效。方法:选取2018年6月至2021年4月苏州大学附属第一医院行OrthoPilot导航辅助下OWHTO病例,并以性别、年龄为条件,匹配同一时间段相同例数的传统器械下OWHTO病例作为对照,最终纳入导航组38例42膝和传统组40例42膝。导航组行OrthoPilot导航辅助OWHTO,传统组行传统器械下OWHTO。记录两组患者围手术期相关指标,包括手术时间、下肢力线位置、目标与实际矫正角度、目标与实际撑开高度,并计算下肢力线位置偏倚值、矫正角度偏倚值和撑开高度偏倚值。观察记录两组患者手术前后影像学评估指标,包括机械胫股角(mTFA)、胫骨近端内侧角(MPTA)、关节线汇聚角(JLCA)。于术前、术后3 d、术后1个月记录膝关节活动度(ROM);于术前、术后1个月、术后1年及末次随访时记录美国特种外科医院膝关节评分(HSS)和Lysholm评分。观察术后1年内患者并发症发生情况。结果:患者随访42~76个月,平均(60.78±9.54)个月。导航组患者手术时间长于传统组,差异有统计学意义(P<0.05);导航组患者术后下肢力线位置、术后矫正角度、术后撑开高度均大于传统组,差异均有统计学意义(P均<0.05)。导航组患者力线位置偏倚值>3%的例数、矫正角度偏倚值、撑开高度偏倚值均小于传统组,差异均有统计学意义(P均<0.05)。术后1 d,导航组患者mTFA、MPTA均大于传统组,差异均有统计学意义(P均<0.05)。术后各个时间点,两组患者膝关节ROM均大于术前,Lysholm评分、HSS均高于术前,差异均有统计学意义(P均<0.05)。术后1年,两组患者膝关节ROM均大于术后3 d,Lysholm评分和HSS均高于术后1个月,差异均有统计学意义(P均<0.05)。末次随访时,两组患者Lysholm评分和HSS均高于术后1个月和术后1年,差异均有统计学意义(P均<0.05)。导航组患者术中合页�Objective:To investigate the mid-term outcomes of OrthoPilot navigation-assisted medial opening wedge high tibial osteotomy(OWHTO)for medial compartment knee osteoarthritis.Methods:Patients who underwent OrthoPilot navigation-assisted OWHTO at the Department of Joint Surgery,the First Affiliated Hospital of Soochow University from June 2018 to April 2021 were selected.Matched cases of OWHTO performed using traditional instruments during the same period were chosen as controls based on gender and age.A total of 42 knees was included in each group,categorized as the navigation group and the traditional group.The navigation group underwent OrthoPilot navigation-assisted OWHTO,while the traditional group underwent OWHTO using traditional instruments.Perioperative indicators of both groups were recorded,including operation time,lower limb alignment,target and actual correction angles,and target and actual opening heights.The deviation values of the lower limb alignment,the correction angle and opening height were calculated.Preoperative and postoperative radiographic assessments,including mechanical tibiofemoral angle(mTFA),medial proximal tibial angle(MPTA),and joint line convergence angle(JLCA),were observed and recorded between the two groups.Knee range of motion(ROM)was recorded preoperatively,at 3 days,and 1 month postoperatively.The Hospital for Special Surgery(HSS)knee score and Lysholm score were recorded preoperatively,at 1 month,1 year postoperatively,and at the final follow-up.The occurrence of complications within 1 year postoperatively was observed.Results:All patients were followed up for 42 to 76 months,with an average of(60.78±9.54)months.The operation time in the navigation group was significantly longer than that in the traditional group(P<0.05).Postoperative lower limb alignment,correction angle,and opening height in the navigation group were significantly greater than those in the traditional group(all P<0.05).The navigation group also showed significantly fewer cases with lower limb alignment dev

关 键 词：胫骨高位截骨术 计算机导航 骨关节炎 中期临床疗效 

分 类 号：R687.4[医药卫生—骨科学]