Department of Orthopaedic Surgery, School of Medicine, University of Oviedo, Oviedo, Spain.
Clin Orthop Relat Res. 2010 May;468(5):1237-41. doi: 10.1007/s11999-009-1175-1.
The accuracy of computer navigation applied to total knee arthroplasty (TKA) in knees with severe deformity has not been studied.
QUESTIONS/PURPOSES: The purpose of this study was to compare the radiographic alignment achieved in total knee replacements performed with and without navigation and to search for differences in the final alignment of two groups of patients (with and without previous joint deformities) using the same system of surgical navigation.
The first series comprised 40 arthroplasties with minimal preoperative deformity. In 20 of them, surgical navigation was used, whereas the other 20 were performed with conventional jig-based technique. We compared the femoral angle, tibial angle, and femorotibial angle (FTA) by performing a post-TKA CT of the entire limb. In the second series, 40 additional TKAs were studied; in this case, however, they presented preoperative deformities greater than 10 masculine in the frontal plane.
The positioning of the femoral and tibial component was more accurate in the group treated with surgical navigation and FTA improvement was statistically significant. When comparing the results of both series, FTA precision was always higher when using computer-assisted surgery. As for optimal FTA, data showed the use of surgical navigation improved the results both in the group with preoperative deformity greater than 10 degrees in the frontal plane and in the group with minimal preoperative knee deformity.
Surgical navigation obtains better radiographic results in the positioning of the femoral and tibial components and in the final axis of the limb in arthroplasties performed on both deformed and more normally aligned knees.
Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
计算机导航应用于严重畸形膝关节全膝关节置换术（TKA）的准确性尚未得到研究。
问题/目的：本研究旨在比较使用和不使用导航进行全膝关节置换术后获得的放射学对线，并使用相同的手术导航系统寻找两组患者（有和没有先前关节畸形）的最终对线差异。
第一组包括 40 例术前畸形最小的关节置换术。其中 20 例采用手术导航，另外 20 例采用传统基于夹具的技术进行。我们通过对整个肢体进行术后 CT 检查比较了股骨角、胫骨角和股胫角（FTA）。在第二组中，另外研究了 40 例 TKA；然而，在这种情况下，它们存在术前畸形大于 10 度的畸形。
在接受手术导航治疗的组中，股骨和胫骨组件的定位更准确，FTA 改善具有统计学意义。当比较两个系列的结果时，计算机辅助手术始终能提供更高的 FTA 精度。至于最佳 FTA，数据显示手术导航的使用改善了术前在额状面畸形大于 10 度的组和术前膝关节畸形较小的组的结果。
手术导航在定位股骨和胫骨组件以及在畸形和更正常对线的膝关节进行关节置换术后肢体的最终轴线上获得更好的放射学结果。
II 级，治疗研究。有关证据水平的完整描述，请参阅作者指南。
