中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2014年
7期
599-602
,共4页
马元琛%廖俊星%林子洪%李梦远%郑秋坚
馬元琛%廖俊星%林子洪%李夢遠%鄭鞦堅
마원침%료준성%림자홍%리몽원%정추견
外科手术,计算机辅助%关节成形术,置换,膝%骨关节炎,膝
外科手術,計算機輔助%關節成形術,置換,膝%骨關節炎,膝
외과수술,계산궤보조%관절성형술,치환,슬%골관절염,슬
Surgery,computer-assisted%Arthroplasty,replacement,knee%Osteoarthritis,knee
目的 探讨计算机导航辅助全膝关节表面置换术治疗膝关节骨关节炎的临床疗效. 方法 回顾性分析2012年5月至12月收治且获随访的38例膝关节骨关节炎患者资料,根据治疗方式不同分为2组:导航组18例,男2例,女16例;原发性骨关节炎13例,创伤性骨关节炎5例;术中应用计算机导航系统进行定位截骨,行全膝关节表面置换术;对照组20例,男1例,女19例;原发性骨关节炎18例,创伤性骨关节炎2例;应用传统的手术器械定位截骨,行全膝关节表面置换术.比较两组患者的手术时间、术后1年美国膝关节协会评分(KSS)、X线片上的下肢轴线和假体位置. 结果 38例患者术后获平均15.8个月(12 ～ 18个月)随访.导航组患者的手术时问[(101.9±10.1)mm]较对照组[(79.5 ±5.0)min]长,胫骨后倾角度(0.5°±0.6°)较对照组(1.6°±1.0°)小,差异均有统计学意义(P＜0.05),而两组患者术后1年KSS评分、机械轴夹角、股骨角度及胫骨角度之间比较差异均无统计学意义(P＞0.05).导航组和对照组患者术后机械轴夹角位于±3°的百分率分别为88.9％(16/18)和70.0％(14/20),差异无统计学意义(P＞0.05).两组患者随访期间均无浅部或深部感染、下肢深静脉血栓形成、髌骨或假体周围骨折、假体松动或下沉等并发症发生. 结论 计算机导航辅助全膝关节表面置换术能够获得与传统全膝关节表面置换术相同的临床疗效,且假体安放角度较传统手术更精确.
目的 探討計算機導航輔助全膝關節錶麵置換術治療膝關節骨關節炎的臨床療效. 方法 迴顧性分析2012年5月至12月收治且穫隨訪的38例膝關節骨關節炎患者資料,根據治療方式不同分為2組:導航組18例,男2例,女16例;原髮性骨關節炎13例,創傷性骨關節炎5例;術中應用計算機導航繫統進行定位截骨,行全膝關節錶麵置換術;對照組20例,男1例,女19例;原髮性骨關節炎18例,創傷性骨關節炎2例;應用傳統的手術器械定位截骨,行全膝關節錶麵置換術.比較兩組患者的手術時間、術後1年美國膝關節協會評分(KSS)、X線片上的下肢軸線和假體位置. 結果 38例患者術後穫平均15.8箇月(12 ～ 18箇月)隨訪.導航組患者的手術時問[(101.9±10.1)mm]較對照組[(79.5 ±5.0)min]長,脛骨後傾角度(0.5°±0.6°)較對照組(1.6°±1.0°)小,差異均有統計學意義(P＜0.05),而兩組患者術後1年KSS評分、機械軸夾角、股骨角度及脛骨角度之間比較差異均無統計學意義(P＞0.05).導航組和對照組患者術後機械軸夾角位于±3°的百分率分彆為88.9％(16/18)和70.0％(14/20),差異無統計學意義(P＞0.05).兩組患者隨訪期間均無淺部或深部感染、下肢深靜脈血栓形成、髕骨或假體週圍骨摺、假體鬆動或下沉等併髮癥髮生. 結論 計算機導航輔助全膝關節錶麵置換術能夠穫得與傳統全膝關節錶麵置換術相同的臨床療效,且假體安放角度較傳統手術更精確.
목적 탐토계산궤도항보조전슬관절표면치환술치료슬관절골관절염적림상료효. 방법 회고성분석2012년5월지12월수치차획수방적38례슬관절골관절염환자자료,근거치료방식불동분위2조:도항조18례,남2례,녀16례;원발성골관절염13례,창상성골관절염5례;술중응용계산궤도항계통진행정위절골,행전슬관절표면치환술;대조조20례,남1례,녀19례;원발성골관절염18례,창상성골관절염2례;응용전통적수술기계정위절골,행전슬관절표면치환술.비교량조환자적수술시간、술후1년미국슬관절협회평분(KSS)、X선편상적하지축선화가체위치. 결과 38례환자술후획평균15.8개월(12 ～ 18개월)수방.도항조환자적수술시문[(101.9±10.1)mm]교대조조[(79.5 ±5.0)min]장,경골후경각도(0.5°±0.6°)교대조조(1.6°±1.0°)소,차이균유통계학의의(P＜0.05),이량조환자술후1년KSS평분、궤계축협각、고골각도급경골각도지간비교차이균무통계학의의(P＞0.05).도항조화대조조환자술후궤계축협각위우±3°적백분솔분별위88.9％(16/18)화70.0％(14/20),차이무통계학의의(P＞0.05).량조환자수방기간균무천부혹심부감염、하지심정맥혈전형성、빈골혹가체주위골절、가체송동혹하침등병발증발생. 결론 계산궤도항보조전슬관절표면치환술능구획득여전통전슬관절표면치환술상동적림상료효,차가체안방각도교전통수술경정학.
Objective To investigate the clinical outcomes of computer-assisted navigation total knee arthroplasty (TKA) for the treatment of knee osteoarthritis.Methods From May to December 2012,38 patients with knee osteoarthritis (OA) were treated with TKA.Computer-assisted navigation was used in 18 of them (2 men and 16 women) with 13 cases of primary OA and 5 ones of traumatic OA.Conventional TKA was conducted in the other 20 patients (one man and 19 women) with 18 cases of primary OA and 2 ones of traumatic OA.The 2 groups were compared in terms of operation time,American Knee Society score (KSS) one year postoperation,mechanical axis of the lower limb and prosthesis alignment on X-ray films.Results The patients were followed up for an average of 15.8 month (from 12 to 18 months).Compared with the conventional group,the navigation group had significantly longer operation time (101.9 ± 10.1 min versus 79.5 ± 5.0 min),a significantly smaller tibial slope angle (0.5°± 0.6° versus 1.6°± 1.0°)(P ＜ 0.05).There were no significant differences between the 2 groups regarding KSS score,included angle of the mechanical axis,femoral angle or tibia angle (P ＞ 0.05).88.9％ (16/18) of the patients in the navigation group and 70.0％ (14/20) of those in the conventional group had an included angle of the mechanical axis of ± 3°,showing no significant difference either (P ＞ 0.05).No infection,lower limb deep venous thrombosis,patellar or peri-prosthetic fracture,prosthetic loosening or collapse was observed in either group.Conclusion Compared with conventional TKA,computer-assisted navigation TKA may achieve similar clinical outcomes but more precise placement of the prosthesis.
