Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan.
Knee Surg Sports Traumatol Arthrosc. 2011 Jun;19(6):904-10. doi: 10.1007/s00167-010-1253-7. Epub 2010 Sep 1.
Correct alignment of the leg and positioning of the components are important factors in good long-term outcome of total knee arthroplasty (TKA). Computer-assisted navigation systems were introduced to improve component alignment accuracies. The three main hypotheses of this study were that the navigated compared to jig-based patient will show the following: (1) No difference in clinical outcomes. (2) Better alignment in the frontal and sagittal plane. (3) Better rotational positioning of components.
The authors evaluated 100 patients who had minimally invasive TKA using either an image-free computer-assisted navigation system (n=50) or a jig-based technique (n=50). Six months postoperatively, clinical and radiological evaluations were performed using full-length standing anteroposterior and lateral radiographs and CT scans of the knee.
Knee Society knee score, function score, and range of motion were comparable in the two groups after surgery. The percentage of patients with a frontal tibiofemoral angle within ±3° of the ideal was significantly higher in the navigated group than in the jig-based group (94% vs. 78%, respectively; P=0.041). No significant differences were found between groups in terms of the frontal and sagittal planes as well as rotational alignment of the femoral or tibial components.
Computer-assisted TKA gives a better correction of alignment of the leg compared with jig-based TKA when combined with a minimally invasive surgical approach.
膝关节置换术（TKA）的良好长期效果的重要因素包括腿部的正确对线和部件的定位。计算机辅助导航系统的引入提高了部件对准精度。本研究的三个主要假设是，与基于夹具的患者相比，导航组将显示以下情况：（1）临床结果无差异。（2）在前额和矢状平面中更好的对准。（3）组件的旋转定位更好。
作者评估了 100 名接受微创 TKA 的患者，他们使用无图像计算机辅助导航系统（n=50）或基于夹具的技术（n=50）。术后 6 个月，通过全膝关节站立前后位和侧位 X 线片以及膝关节 CT 扫描进行临床和影像学评估。
手术后两组的膝关节学会膝关节评分、功能评分和运动范围相当。在导航组中，有 94%的患者在前额胫骨股骨角在理想角度的±3°范围内，明显高于基于夹具组（分别为 78%；P=0.041）。在额状面和矢状面以及股骨或胫骨部件的旋转对准方面，两组之间没有发现显著差异。
与基于夹具的 TKA 相比，当与微创手术方法结合使用时，计算机辅助 TKA 可更好地纠正腿部的对线。
