Chung Byung June, Dileep Isaac, Chang Chong Bum, Kang Yeon Gwi, Park Yong Bum, Kim Tae Kyun
Joint Reconstruction Center, Seoul National University Bundang Hospital, Seongnam, Korea.
Orthopedics. 2010 Oct;33(10 Suppl):62-7. doi: 10.3928/01477447-20100510-56.
This study was conducted (1) to document discrepancies between preoperative and postoperative radiographic measurements and postregistration and postimplantation intraoperative navigational measurements of coronal limb alignments, and (2) to identify predictors of discrepancies between radiographic and navigational measures. In addition, we propose the use of a novel radiographic measuring method, and we demonstrate that this method reduces discrepancies. For 107 total knee arthroplasties performed using a navigation system, coronal alignment were assessed using preoperative and postoperative whole limb radiographs using the standard and novel radiographic methods. During surgery, coronal limb alignment was measured using the navigation system postregistration and postprosthesis implantation. Strengths of correlations and discrepancies between radiographic and navigational assessments were compared between the standard and novel methods. Multivariate regression was performed to identify predictors of discrepancies. Differences between radiographic and navigational measurements were observed for both preoperative and postoperative assessments, but discrepancies were greater for preoperative assessments, despite their stronger correlations. Extent of preoperative varus deformity was identified as the strongest predictor of discrepancy in preoperative radiographic and navigational measurements, and varus malalignment was identified as the strongest predictor of discrepancy in postoperative measurements. Strengths of correlations between radiographic and navigational measurements were similar for the standard and novel radiographic methods, but discrepancies between the 2 were significantly smaller for the novel method for both preoperative and postoperative assessments. The authors propose the use of the described novel radiographic method that reduces discrepancies between radiographic and navigational measurements.
（1）记录术前与术后影像学测量以及注册后与植入后术中冠状位肢体对线导航测量之间的差异；（2）确定影像学测量与导航测量之间差异的预测因素。此外，我们提出使用一种新的影像学测量方法，并证明该方法可减少差异。对于使用导航系统进行的107例全膝关节置换术，使用标准和新的影像学方法，通过术前和术后全肢体X线片评估冠状位对线。在手术过程中，使用导航系统在注册后和假体植入后测量冠状位肢体对线。比较标准方法和新方法在影像学评估与导航评估之间的相关性强度和差异。进行多变量回归以确定差异的预测因素。术前和术后评估均观察到影像学测量与导航测量之间的差异，但术前评估的差异更大，尽管它们的相关性更强。术前内翻畸形程度被确定为术前影像学和导航测量差异的最强预测因素，内翻畸形被确定为术后测量差异的最强预测因素。标准影像学方法和新影像学方法在影像学测量与导航测量之间的相关性强度相似，但对于术前和术后评估，新方法在两者之间的差异均显著更小。作者建议使用所描述的新影像学方法，该方法可减少影像学测量与导航测量之间的差异。
