Rath B, Springorum H-R, Beckmann J, Schaumburger J, Tingart M, Grifka J, Lüring C
Orthopädische Klinik, Universität Regensburg, Asklepios-Klinikum Bad Abbach.
Z Orthop Unfall. 2011 Apr;149(2):173-7. doi: 10.1055/s-0030-1250469. Epub 2011 Jan 17.
Total knee arthroplasty is one of the standard procedures in severe osteoarthritis of the knee. Computer-assisted navigation systems became more popular in the last decade. Navigation systems improve the component positioning and the alignment in total knee arthroplasties. The aim of this survey was to capture the actual trend in computer-assisted total knee arthroplasties in Germany and to discuss the results in comparison to the current literature.
A questionnaire form was sent to 506 orthopaedic and trauma surgery departments in Germany. The first part of the survey included general questions about the department and total knee arthroplasties. The surgeons were asked about their application behaviour and their rating of computer-assisted navigation in total knee arthroplasty in the second part. Questions concerning total knee arthroplasties, unicondylar knee arthroplasties and revision total knee arthroplasties were included in the form.
194 of the departments returned the questionnaire. A total of 39 941 knee arthroplasty surgeries were performed in these departments. 35 624 of these surgeries were primary knee arthroplasties including 32 789 total knee arthroplasties and 2835 unicondylar knee arthroplasties. In addition, 4317 revision total knee arthroplasties were performed by the respondents. 60 % of the departments used a computer-assisted navigation system. In synopsis 29 % of the primary total knee arthroplasties, 4 % of the unicondylar knee arthroplasties and 7 % of the revision knee arthroplasties were performed with a computer-assisted navigation system. Minimal invasive surgery was performed in 31 % of the departments and 36 % of these surgeries were done with navigation-assistance. The "ligament-balanced" procedure was the most common used technique to determine the femur rotation in navigated total knee arthroplasties. In 75 % of navigated total knee arthroplasties cemented components were implanted. Overall 65 % of respondents approved of navigation-assisted surgeries and 77 % saw an improved precision by this technique. The number of computer-assisted navigation uses in surgeries is increasing in 34 % of the departments and decreasing in 13 %.
The computer-assisted navigation in total knee arthroplasties is a frequently used technique. The most respondents support the application of navigation-assisted knee arthroplasties and indicate an improved outcome measured by the postoperative alignment. Nevertheless, long-term results are needed for a final evaluation of navigation-assisted surgery.
全膝关节置换术是重度膝关节骨关节炎的标准手术之一。在过去十年中，计算机辅助导航系统越来越受欢迎。导航系统可改善全膝关节置换术中假体的定位和对线。本调查的目的是了解德国计算机辅助全膝关节置换术的实际趋势，并与当前文献中的结果进行讨论。
向德国506个骨科和创伤外科科室发送了一份问卷。调查的第一部分包括有关科室和全膝关节置换术的一般问题。第二部分询问了外科医生在全膝关节置换术中的应用行为以及他们对计算机辅助导航的评价。问卷中还包括有关全膝关节置换术、单髁膝关节置换术和翻修全膝关节置换术的问题。
194个科室返回了问卷。这些科室共进行了39941例膝关节置换手术。其中35624例为初次膝关节置换术，包括32789例全膝关节置换术和2835例单髁膝关节置换术。此外，受访者还进行了4317例翻修全膝关节置换术。60%的科室使用计算机辅助导航系统。概括而言，29%的初次全膝关节置换术、4%的单髁膝关节置换术和7%的翻修膝关节置换术是在计算机辅助导航系统下进行的。31%的科室开展了微创手术，其中36%的手术在导航辅助下完成。“韧带平衡”手术是导航全膝关节置换术中确定股骨旋转最常用的技术。在75%的导航全膝关节置换术中植入了骨水泥型假体。总体而言，65%的受访者认可导航辅助手术，77%的受访者认为该技术提高了手术精度。34%的科室手术中计算机辅助导航的使用次数在增加，13%的科室在减少。
全膝关节置换术中的计算机辅助导航是一种常用技术。大多数受访者支持导航辅助膝关节置换术的应用，并指出术后对线情况有所改善。然而，导航辅助手术的最终评估需要长期结果。
