Wang Gongli, Zheng Guoyan, Gruetzner Paul Alfred, Mueller-Alsbach Urs, von Recum Jan, Staubli Alex, Nolte Lutz-Peter
M.E. Mueller Research Center for Orthopaedic Surgery, University of Bern, Bern, Switzerland.
Technol Health Care. 2005;13(6):469-83.
High tibial osteotomy is a widely accepted treatment for unicompartmental osteoarthritis of the knee and other lower extremity deformities, particularly in young and active patients. However, it is generally recognized as a technically demanding procedure. The lack of intraoperative control of the mechanical axis of the affected limb often results in postoperative malalignments, which is one of the main reasons for poor long-term results. Moreover, inaccurate osteotomies, such as insufficient or excessive bone cut, or incorrect orientation of the chisel or saw blade, have been observed. A computer assisted intraoperative planning and navigation system is therefore proposed in order to address these technical problems. During operation, fluoroscopic images are acquired and anatomical landmarks are digitized; a patient-specific coordinate system is established accordingly. After the three-dimensional measurement of the deformity and interactive planning of the osteotomy plane, the deformity is corrected under navigational guidance. The proposed system has been successfully introduced into the clinical practice of surgery after encouraging laboratory evaluations, with results affirming that it is safe and accurate.
高位胫骨截骨术是治疗膝关节单髁骨关节炎及其他下肢畸形的一种广泛接受的方法，尤其适用于年轻且活跃的患者。然而，它通常被认为是一项技术要求很高的手术。术中对患肢机械轴缺乏控制常常导致术后对线不良，这是长期效果不佳的主要原因之一。此外，还观察到截骨不准确的情况，如截骨量不足或过多，或凿子或锯片的方向不正确。因此，为了解决这些技术问题，提出了一种计算机辅助术中规划和导航系统。在手术过程中，采集荧光透视图像并将解剖标志数字化；据此建立患者特定的坐标系。在对畸形进行三维测量并对截骨平面进行交互式规划后，在导航引导下矫正畸形。经过令人鼓舞的实验室评估后，该系统已成功引入外科临床实践，结果证实其安全且准确。
