Spencer J M, Chauhan S K, Sloan K, Taylor A, Beaver R J
Royal Perth Hospital, Perth, Western Australia.
J Bone Joint Surg Br. 2007 Apr;89(4):477-80. doi: 10.1302/0301-620X.89B4.18094.
We previously compared the component alignment in total knee replacement using a computer-navigated technique with a conventional jig-based method. We randomly allocated 71 patients to undergo either computer-navigated or conventional replacement. An improved alignment was seen in the computer-navigated group. The patients were then followed up post-operatively for two years, using the Knee Society score, the Short Form-36 health survey, the Western Ontario and McMaster Universities osteoarthritis index, the Bartlett Patellar pain questionnaire and the Oxford knee score, to assess functional outcome. At two years post-operatively 60 patients were available for assessment, 30 in each group and 62 patients completed a postal survey. No patient in either group had undergone revision. All variables were analysed for differences between the groups either by Student's t-test or the Mann-Whitney U test. Differences between the two groups did not reach significance for any of the outcome measures at any time point. At two years postoperatively, the frequency of mild to severe anterior pain was not significantly different (p = 0.818), varying between 44% (14) for the computer-navigated group, and 47% (14) for the conventionally-replaced group. The Bartlett Patellar score and the Oxford knee score were also not significantly different (t-test p = 0.161 and p = 0.607, respectively). The clinical outcome of the patients with a computer-navigated knee replacement appears to be no different to that of a more conventional jig-based technique at two years post-operatively, despite the better alignment achieved with computer-navigated surgery.
我们之前比较了在全膝关节置换术中使用计算机导航技术与传统基于夹具的方法时组件的对线情况。我们随机分配71例患者接受计算机导航或传统置换。在计算机导航组中观察到对线有所改善。然后对患者进行术后两年的随访,使用膝关节协会评分、简短健康调查问卷36项、西安大略和麦克马斯特大学骨关节炎指数、巴特利特髌骨疼痛问卷以及牛津膝关节评分来评估功能结果。术后两年时,有60例患者可供评估,每组30例,62例患者完成了邮寄调查。两组中均无患者接受翻修手术。所有变量均通过学生t检验或曼-惠特尼U检验分析组间差异。在任何时间点,两组之间的差异在任何一项结果指标上均未达到显著水平。术后两年时,轻度至重度前膝疼痛的发生率无显著差异(p = 0.818),计算机导航组为44%(14例),传统置换组为47%(14例)。巴特利特髌骨评分和牛津膝关节评分也无显著差异(t检验,p分别为0.161和0.607)。尽管计算机导航手术实现了更好的对线,但在术后两年时,接受计算机导航膝关节置换的患者的临床结果似乎与更传统的基于夹具的技术并无不同。