Yaffe Mark A, Koo Samuel S, Stulberg S David
Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Clin Orthop Relat Res. 2008 Nov;466(11):2736-44. doi: 10.1007/s11999-008-0427-9.
Precise pre- and postoperative anatomic measurements are necessary to plan, perform, and evaluate total knee arthroplasty (TKA). We evaluated the relationship between radiographic and navigation alignment measurements, identified sources of error in radiographic and navigated alignment assessment, and determined the differences between desired and clinically accepted alignment. Fifty-eight computer-assisted TKAs were performed and limb alignment measurements were recorded both pre- and postoperatively with standard radiographs and with an intraoperative navigation system. Intraoperative navigation produced consistent navigation-generated alignment results that were within 1 degrees of the desired alignment. The difference between preoperative radiographic and navigation measurements varied by as much as 12 degrees and the difference between postoperative radiographic and navigation measurements varied by as much as 8 degrees. This discrepancy depended on the degree of limb deformity. Postoperative radiographic measurements have inherent limitations. Navigation can generate precise, accurate, and reproducible alignment measurements. This technology can function as an effective tool for assessing pre- and postoperative limb alignment and relating intraoperative alignment measurements to clinical and functional outcomes.
Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
精确的术前和术后解剖测量对于全膝关节置换术（TKA）的规划、实施和评估是必要的。我们评估了影像学和导航对线测量之间的关系，确定了影像学和导航对线评估中的误差来源，并确定了期望对线与临床可接受对线之间的差异。进行了58例计算机辅助全膝关节置换术，并在术前和术后分别用标准X线片和术中导航系统记录肢体对线测量值。术中导航产生的导航生成的对线结果与期望对线相差在1度以内。术前影像学测量与导航测量之间的差异高达12度，术后影像学测量与导航测量之间的差异高达8度。这种差异取决于肢体畸形的程度。术后影像学测量存在固有局限性。导航可以生成精确、准确且可重复的对线测量值。这项技术可以作为评估术前和术后肢体对线以及将术中对线测量与临床和功能结果相关联的有效工具。
II级，治疗性研究。有关证据水平的完整描述，请参阅作者指南。
