CAJ | 학술논문

目的探讨在计算机导航下骨解剖异常的全膝关节置换术(total knee arthroplasty,TKA)的疗效及其优越性.方法 2007年12月-2008年10月共对5例骨解剖异常的膝关节行TKA(导航组),手术均在计算机导航辅助下进行.随机选取既往未使用计算机导航的5例行TKA患者作为非导航组,均具有正常解剖标志.术后3 d常规摄正、侧位X线片,分别测量α、β、γδ角及关节活动度.结果术中、术后未发生因导航而出现的并发症.两组α、β、γ及δ角虽然差异无统计学意义,但导航组的极值范围很小,其取得极值的可能性远远小于非导航组.术后导航组膝关节活动范围平均为112.67°,非导航组为106.98°,但两组术前活动范围[导航组(70.87±10.78)°,非导航组(105.08±30.67)°]比较,差异有统计学意义.结论计算机导航下TRA的近期疗效与机械定位相比无明显优势,但在力线上均明显较机械定位精确.计算机导航下TKA特别对于解剖异常的膝关节,可降低手术难度,提高手术精度.
목적 탐토재계산궤도항하골해부이상적전슬관절치환술(total knee arthroplasty,TKA)적료효급기우월성.방법 2007년12월-2008년10월공대5례골해부이상적슬관절행TKA(도항조),수술균재계산궤도항보조하진행.수궤선취기왕미사용계산궤도항적5례행TKA환자작위비도항조,균구유정상해부표지.술후3 d상규섭정、측위X선편,분별측량α、β、γδ각급관절활동도.결과 술중、술후미발생인도항이출현적병발증.량조α、β、γ급δ각수연차이무통계학의의,단도항조적겁치범위흔소,기취득겁치적가능성원원소우비도항조.술후도항조슬관절활동범위평균위112.67°,비도항조위106.98°,단량조술전활동범위[도항조(70.87±10.78)°,비도항조(105.08±30.67)°]비교,차이유통계학의의.결론 계산궤도항하TRA적근기료효여궤계정위상비무명현우세,단재력선상균명현교궤계정위정학.계산궤도항하TKA특별대우해부이상적슬관절,가강저수술난도,제고수술정도.
Objective To discuss the effect and advantage of the navigation-assisted system in total knee arthroplasty (TKA) of the knees with anatomical abnormality. Methods The study involved five patients with anatomical abnormality of the knees who were treated with arthroplasty under the navigation-assisted system from December 2007 to October 2008. Meanwhile, five patients with normal anatomy of the knees treated with total knee arthroplasty without using the navigation-assisted system were used as control. The α, β, γand δ angles were measured based on the X-ray images and the active range of the knee joint was determined. Results No complication caused by navigation occurred. There was no significant difference in the α, β, γ and δ angles between the two groups, but the range of extremum in the navigation group was less than that of the control group. The mean postoperative active range of the knee joint in the navigation group ( 112.67°) was higher than that of the control group ( 106.98° ), while the preoperative active range of the knee joint of the navigation group [(70.87 ± 10.87)°] was significantly lower than that of the control group [( 105.08 ± 30.67)°]. Conclusions Compared with conventional methods, navigation-assisted TKA showas no obvious advantage in short-term outcome but has great advantages in improving the accuracy and the joint movement, especially for the knees with anatomical abnormality.