中国骨与关节杂志
中國骨與關節雜誌
중국골여관절잡지
Chinese Journal of Bone and Joint
2013年
7期
396-401
,共6页
崔文权%姜文学%元礼渊%齐志明%毕伟%韩亚洲
崔文權%薑文學%元禮淵%齊誌明%畢偉%韓亞洲
최문권%강문학%원례연%제지명%필위%한아주
关节成形术,置换%外科手术,计算机辅助%电磁辐射%外科手术%膝关节
關節成形術,置換%外科手術,計算機輔助%電磁輻射%外科手術%膝關節
관절성형술,치환%외과수술,계산궤보조%전자복사%외과수술%슬관절
Arthroplasty,replacement%Surgery,computer-assisted%Electromagnetic radiation%Surgical procedures,operative%Knee joint
目的回顾性评价电磁导航辅助全膝关节置换( total knee arthroplasty，TKA )术后假体植入和重建下肢力线的准确性，探讨应用电磁导航系统施行全膝关节置换术的技术特点和早期临床疗效。方法对2006年7月至2007年2月电磁导航辅助初次 TKA 的初始连续病例64例100膝进行回顾性研究，男7例，女57例；年龄57～79岁，平均66.9岁。术后观察导航时间，止血带时间、出血量和48 h 引流量。X 线评估包括测量术前和术后3个月下肢机械轴线角，股骨、胫骨假体的冠状面倾斜角(α角和β角)和股骨假体矢状面倾斜角(γ角)。内翻表示为“+”，外翻表示为“-”。观察手术前、术后3个月的 KSS 评分膝关节功能、膝关节屈伸活动度( ranges of motion，ROM )和并发症。结果导航时间为(10±2) min/膝，止血带时间为(93±9) min。48 h 出血量、引流量为(483±55) ml。手术前后机械轴线角分别为(+8.07±6.69)°，(+1.20±1.92)°，两者差异有统计学意义( P＜0.05)。术后α角为(89.33±1.64)°，β角为(89.64±1.47)°，γ角为(90.86±2.37)°，术前和术后3个月 KSS 评分分别为(86±18)分和(137±26)分，两者差异有统计学意义( P＜0.05)。术前和术后3个月 ROM 分别为(92±21)°和(108±24)°，差异有统计学意义( P＜0.05)。术后下肢机械轴线、α角、β角和γ角与术后 KSS 评分、ROM 间的相关性均无统计学意义( P＞0.05)。术后无感染、血管神经损伤、骨折、下肢深静脉血栓形成等并发症发生。结论电磁导航系统是安全可靠的，应用该系统行 TKA 可获得理想的假体位置和下肢力线，以及早期优良的临床疗效。
目的迴顧性評價電磁導航輔助全膝關節置換( total knee arthroplasty，TKA )術後假體植入和重建下肢力線的準確性，探討應用電磁導航繫統施行全膝關節置換術的技術特點和早期臨床療效。方法對2006年7月至2007年2月電磁導航輔助初次 TKA 的初始連續病例64例100膝進行迴顧性研究，男7例，女57例；年齡57～79歲，平均66.9歲。術後觀察導航時間，止血帶時間、齣血量和48 h 引流量。X 線評估包括測量術前和術後3箇月下肢機械軸線角，股骨、脛骨假體的冠狀麵傾斜角(α角和β角)和股骨假體矢狀麵傾斜角(γ角)。內翻錶示為“+”，外翻錶示為“-”。觀察手術前、術後3箇月的 KSS 評分膝關節功能、膝關節屈伸活動度( ranges of motion，ROM )和併髮癥。結果導航時間為(10±2) min/膝，止血帶時間為(93±9) min。48 h 齣血量、引流量為(483±55) ml。手術前後機械軸線角分彆為(+8.07±6.69)°，(+1.20±1.92)°，兩者差異有統計學意義( P＜0.05)。術後α角為(89.33±1.64)°，β角為(89.64±1.47)°，γ角為(90.86±2.37)°，術前和術後3箇月 KSS 評分分彆為(86±18)分和(137±26)分，兩者差異有統計學意義( P＜0.05)。術前和術後3箇月 ROM 分彆為(92±21)°和(108±24)°，差異有統計學意義( P＜0.05)。術後下肢機械軸線、α角、β角和γ角與術後 KSS 評分、ROM 間的相關性均無統計學意義( P＞0.05)。術後無感染、血管神經損傷、骨摺、下肢深靜脈血栓形成等併髮癥髮生。結論電磁導航繫統是安全可靠的，應用該繫統行 TKA 可穫得理想的假體位置和下肢力線，以及早期優良的臨床療效。
목적회고성평개전자도항보조전슬관절치환( total knee arthroplasty，TKA )술후가체식입화중건하지력선적준학성，탐토응용전자도항계통시행전슬관절치환술적기술특점화조기림상료효。방법대2006년7월지2007년2월전자도항보조초차 TKA 적초시련속병례64례100슬진행회고성연구，남7례，녀57례；년령57～79세，평균66.9세。술후관찰도항시간，지혈대시간、출혈량화48 h 인류량。X 선평고포괄측량술전화술후3개월하지궤계축선각，고골、경골가체적관상면경사각(α각화β각)화고골가체시상면경사각(γ각)。내번표시위“+”，외번표시위“-”。관찰수술전、술후3개월적 KSS 평분슬관절공능、슬관절굴신활동도( ranges of motion，ROM )화병발증。결과도항시간위(10±2) min/슬，지혈대시간위(93±9) min。48 h 출혈량、인류량위(483±55) ml。수술전후궤계축선각분별위(+8.07±6.69)°，(+1.20±1.92)°，량자차이유통계학의의( P＜0.05)。술후α각위(89.33±1.64)°，β각위(89.64±1.47)°，γ각위(90.86±2.37)°，술전화술후3개월 KSS 평분분별위(86±18)분화(137±26)분，량자차이유통계학의의( P＜0.05)。술전화술후3개월 ROM 분별위(92±21)°화(108±24)°，차이유통계학의의( P＜0.05)。술후하지궤계축선、α각、β각화γ각여술후 KSS 평분、ROM 간적상관성균무통계학의의( P＞0.05)。술후무감염、혈관신경손상、골절、하지심정맥혈전형성등병발증발생。결론전자도항계통시안전가고적，응용해계통행 TKA 가획득이상적가체위치화하지력선，이급조기우량적림상료효。
Objective To retrospectively evaluate the accuracy of postoperative prosthesis implantation and reconstruction of lower limb alignment after total knee arthroplasty ( TKA ) using an electromagnetic ( EM ) navigation system, and to investigate the technical characteristics and early clinical results of EM navigation assisted TKA. Methods The data of 64 initial consecutive patients ( 100 knees ) who underwent primary TKA using an EM navigation system from July 2006 to February 2007 were retrospectively studied. There were 7 males and 57 females, whose mean age was 66.9 years old ( range; 57-79 years ). The navigation time, tourniquet time, blood loss and drainage flow in 48h were observed after the operation. The mechanical axis angle of the lower extremity, the coronal inclination angle of femoral and tibial prostheses and the sagittal inclination angle of femoral prostheses (α,βandγangles ) were measured based on X-rays before the operation and at the 3rd month after the operation. Varus was expressed as positive (+) and valgus negative (-). The knee function was evaluated using the Knee Society Score ( KSS ) before the operation and at the 3rd month after the operation, and the knee joint flexion and extension range of motion ( ROM ) and complications were also recorded. Results The navigation time was ( 10±2 ) min for each knee, and the tourniquet time was ( 93±9 ) min. The blood loss and drainage flow in 48 h were ( 483±55 ) ml. The preoperative and postoperative mechanical axis angles were (+8.07±6.69 ) ° and (+1.20±1.92 ) ° respectively, and statistically significant differences were found between them ( P<0.05 ). The postoperativeαangle,βangle andγangle were ( 89.33±1.64 ) °, ( 89.64±1.47 ) ° and ( 90.86±2.37 ) ° respectively. The KSS scores were ( 86±18 ) points and ( 137±26 ) points respectively before the operation and at the 3rd month after the operation, and statistically significant differences were found between them ( P<0.05 ). The ROM were ( 92±21 ) ° and ( 108±24 ) ° respectively before the operation and at the 3rd month after the operation, and statistically significant differences were found between them ( P<0.05 ). There were no statistically significant correlations between the postoperative mechanical axis angle of the lower extremity,αangle,βangle,γangle and the postoperative KSS and ROM ( P>0.05 ). No complications such as infection, injuries of nerves and blood vessels, bone fractures, deep venous thrombosis of the lower extremity and so on were found. Conclusions The EM navigation system is safe and reliable. With the EM navigation system in TKA, optimal prosthesis position and lower limb alignment and good early clinical results can be achieved.
