Yu Zhong, Wang Li-Ming, Gui Jian-Chao, Hou Ming-Fu, Yao Jing-Dong, Song Hua-Rong, Xu Yan
Department of Orthopedic, Nanjing First Hospital Affiliated To Nanjing Medical University, Nanjing 210006, China.
Zhonghua Yi Xue Za Zhi. 2007 Dec 18;87(47):3335-8.
To investigate the curative effect of virtual image-guided minimal incision sugary unicondylar knee arthroplasty (MIS-UKA).
Twenty-six patients of knee osteoarthritis (with 26 knees) received virtual image-guided MIS-UKA and followed up for (8.2 +/- 2.4) months. The incision length, operative time, hemorrhage, and 48 h drainage were calculated. The patients were evaluated by hand injury severity score (HISS) system knee score. X-ray film of the whole lower limb was taken to observe the line of force and range of motion of knee.
MIS-UKA was successfully performed on the 26 knees with the average incision length of 7.4 +/- 0.6 cm, the average operative time of 78 +/- 12 min, the average hemorrhage of 114 +/- 18 ml, and the 48 h drainage of 122 +/- 13 ml. Two weeks after the operation, the average HISS hip score was 98, higher than that before the operation (72), the hip-knee-ankle angle was 0.8 degree +/- 0.6 degree, larger than that before the operation (7.6 degrees +/- 1.8 degrees), the flexion contraction angle was 1.8 degrees +/- 1.1 degrees, smaller than that before the operation (6.8 degrees +/- 1.6 degrees), and the joint range of motion of knee was 132.6 degrees +/- 3.5 degrees, larger than that before the operation (107.5 degrees +/- 6.2 degrees). No infection, prosthesis cacothesis, and patellofemoral joint pain were found.
The surgical navigation system surmounts the disadvantage of small visual field, observes the line of force of the lower limbs, knee joint rotational apposition, and ligament balance dynamically with digital 3D bone mode, provide geometry and morphology data, and rebuilds knee joint vitodynamically and anatomically, and heightens the accuracy of prostheses replacement, thus having important clinic value in MIS-UKA.
探讨虚拟影像引导下微创单髁膝关节置换术（MIS-UKA）的疗效。
26例膝关节骨关节炎患者（26膝）接受虚拟影像引导下的MIS-UKA，并随访（8.2±2.4）个月。计算切口长度、手术时间、出血量及48小时引流量。采用手损伤严重程度评分（HISS）系统对患者膝关节进行评分。拍摄全下肢X线片观察下肢力线及膝关节活动度。
26膝均成功实施MIS-UKA，平均切口长度为7.4±0.6cm，平均手术时间为78±12分钟，平均出血量为114±18ml，48小时引流量为122±13ml。术后2周，平均HISS髋关节评分为98分，高于术前（72分）；髋-膝-踝角为0.8°±0.6°，大于术前（7.6°±1.8°）；屈曲挛缩角为1.8°±1.1°，小于术前（6.8°±1.6°）；膝关节活动范围为132.6°±3.5°，大于术前（107.5°±6.2°）。未发现感染、假体磨损及髌股关节疼痛。
手术导航系统克服了视野小的缺点，以数字3D骨模式动态观察下肢力线、膝关节旋转对位及韧带平衡，提供几何和形态学数据，对膝关节进行动态和解剖学重建，提高了假体置换的准确性，在MIS-UKA中具有重要的临床价值。
