Fehring Thomas K, Mason J Bohannon, Moskal Joseph, Pollock David C, Mann John, Williams Vincent J
OrthoCarolina Hip and Knee Center, Charlotte, NC 28207, USA.
Clin Orthop Relat Res. 2006 Nov;452:132-6. doi: 10.1097/01.blo.0000229363.50361.25.
We studied whether computer-assisted surgery could properly align total knee arthroplasty when traditional instrumentation was not possible or appropriate. We identified 16 patients (18 knees) who we believed could not be treated using traditional instrumentation because of posttraumatic femoral deformity, retained femoral hardware, a history of osteomyelitis, or severe cardiopulmonary disease. Computer-assisted surgery was successfully used in 17 knees; we were unable to accurately register the hip in one morbidly obese patient. We judged the overall mechanical axis of the limb using computer-assisted surgery acceptable in 16 of 17 knees. One patient with a major posttraumatic biplane deformity had an overall mechanical axis in 4 degrees of varus. Computer-assisted navigation seemed helpful in difficult situations where accurate alignment remains crucial, yet traditional instrumentation is not applicable.
我们研究了在无法使用或不适合使用传统器械的情况下，计算机辅助手术能否正确对齐全膝关节置换术。我们确定了16例患者（18个膝关节），我们认为由于创伤后股骨畸形、股骨内固定物残留、骨髓炎病史或严重心肺疾病，这些患者无法使用传统器械进行治疗。计算机辅助手术在17个膝关节中成功应用；在1例病态肥胖患者中，我们无法准确记录髋关节位置。我们通过计算机辅助手术判断，17个膝关节中有16个膝关节的肢体整体机械轴可接受。1例有严重创伤后双平面畸形的患者，其整体机械轴有4度内翻。在精确对齐仍然至关重要但传统器械不适用的困难情况下，计算机辅助导航似乎很有帮助。
