CAJ | 학술논문

目的比较电磁导航辅助与常规全膝关节置换(total knee arthroplasty,TKA)术后的下肢力线与假体位置.方法电磁导航辅助初次TKA连续病例64例100膝(导航组),非同期常规初次TKA连续病例62例100膝(常规组).比较术后3个月双下肢全长X线片及膝关节正侧位X线片上的机械轴线角,股骨、胫骨假体冠状面倾斜角(α角和β角),股骨假体矢状面倾斜角(γ角).结果导航组机械轴线角为1.20°±1.92°,常规组2.31°±2.25°,差异有统计学意义;导航组α角为89.33°±1.64°,常规组88.68°±2.57°,差异有统计学意义.导航组β角为89.64°±1.47°,常规组89.26°±2.05°,差异无统计学意义;导航组γ角为90.86°±2.37°,常规组90.59°±3.44°,差异无统计学意义.术后机械轴线角误差在±3°内者导航组占86％,常规组79％,差异无统计学意义;α角误差≤90°±3°者导航组占92％,常规组77％,差异有统计学意义;两组β角和γ角误差≤90°±3°者所占比例的差异均无统计学意义.结论电磁导航辅助较常规TKA可获得更加精确的假体位置和下肢力线,其优势主要体现在股骨侧力线矫正而非胫骨侧.
목적 비교전자도항보조여상규전슬관절치환(total knee arthroplasty,TKA)술후적하지력선여가체위치.방법 전자도항보조초차TKA련속병례64례100슬(도항조),비동기상규초차TKA련속병례62례100슬(상규조).비교술후3개월쌍하지전장X선편급슬관절정측위X선편상적궤계축선각,고골、경골가체관상면경사각(α각화β각),고골가체시상면경사각(γ각).결과 도항조궤계축선각위1.20°±1.92°,상규조2.31°±2.25°,차이유통계학의의;도항조α각위89.33°±1.64°,상규조88.68°±2.57°,차이유통계학의의.도항조β각위89.64°±1.47°,상규조89.26°±2.05°,차이무통계학의의;도항조γ각위90.86°±2.37°,상규조90.59°±3.44°,차이무통계학의의.술후궤계축선각오차재±3°내자도항조점86％,상규조79％,차이무통계학의의;α각오차≤90°±3°자도항조점92％,상규조77％,차이유통계학의의;량조β각화γ각오차≤90°±3°자소점비례적차이균무통계학의의.결론 전자도항보조교상규TKA가획득경가정학적가체위치화하지력선,기우세주요체현재고골측력선교정이비경골측.
Objective To compare the lower limb alignment and prosthesis position after total knee arthroplasty (TKA) with or without using electromagnetic navigation.Methods Sixty-four patients (100 knees) underwent TKA under electromagnetic navigation,while 62 patients (100 knees) underwent conventional TKA.Three months after operation,the mechanical axial line angle and prosthesis position (angels α,β,γ) were measured via the full-length radiograph of both lower limbs and anteriorposterior and lateral Xrays of the knee.Results The average mechanical axial line angle and angle α were 1.20°±1.92°and 89.33°±1.64° in navigation group,respectively,and 2.31°±2.25° and 88.68°±2.57° in conventional group.And the differences were significant with regard to the above two indexes between two groups.The average angle β and angle γ were 89.64°±1.47° and 90.86°±2.37° in navigation group,respectively,and 89.26°±2.05° and 90.59°±3.44° in conventional group.However,the differences were not significant with regard to the above two indexes between two groups.After operation,mechanical axial line angle error was within ±3°in 86％ of patients in navigation group,while in 79％ of patients in conventional group; there was no significant difference between them.The angle α error was within 90°±3° in 92％ of patients in navigation group,while in 77％ of patients in conventional group; there was significant difference between them.However,there were no significant differences in percentage of patients whose errors of angle β and angle γ were within 90°±3° between two groups.Conclusion With using electromagnetic navigation in TKA,more precise prosthesis position and the mechanical axis can be achieved compared with the conventional technique.And its advantages mainly contribute to the coronal plane of the femoral side rather than the tibial side.