Department of Orthopaedic Surgery, General Hospital of the People's Liberation Army (PLA), Beijing, China.
J Bone Joint Surg Am. 2011 Jul 6;93(13):1190-6. doi: 10.2106/JBJS.I.01778.
Total knee arthroplasty has been increasingly used for young and active patients, and prosthesis durability is important in these patients. The accuracy of implant placement has been one of the major factors that determine the long-term survival of the prosthesis. The purpose of this study was to compare the accuracy of prosthetic alignment between computer-assisted-navigation and conventional total knee arthroplasties.
From March 2007 to June 2008, thirty-two patients with bilateral knee osteoarthritis underwent simultaneous bilateral total knee arthroplasty with the same type of implant in each knee. The subjects included seven men and twenty-five women, with an average age of sixty-three years. For each patient, the bilateral total knee arthroplasty was performed with computer-assisted navigation in one knee and a conventional technique in the other. The operative technique and the order of the surgical procedures were randomized. The patients and surgeons conducting the follow-up study and performing the imaging measurements were blinded to the type of surgical procedure.
There was a significant difference between the two groups with regard to the alignment of the knee prosthesis in the coronal and sagittal planes. Nine knee implants (28%) in the conventional group, compared with no knee implants in the computer-navigation group, deviated >3° from the mechanical axis in the coronal plane. The coefficient variation of data in the conventional group was three times greater than that in the computer-navigation group. There was no significant difference in the rotational angle of the femoral component between the two groups. The Hospital for Special Surgery (HSS) scores at six months postoperatively were substantially increased compared with the preoperative scores in both groups.
Computer-assisted navigation consistently provided coronal plane alignment within 3° of the mechanical axis, which was significantly better than the alignment obtained with conventional total knee arthroplasty.
全膝关节置换术已越来越多地用于年轻且活跃的患者，而假体的耐用性对于这些患者很重要。植入物放置的准确性是决定假体长期存活率的主要因素之一。本研究的目的是比较计算机辅助导航和常规全膝关节置换术的假体对线准确性。
2007 年 3 月至 2008 年 6 月，32 例双侧膝关节骨关节炎患者同期双侧膝关节行同种假体全膝关节置换术，每侧膝关节 7 例男性，25 例女性，平均年龄 63 岁。每位患者的双侧全膝关节置换术，一侧采用计算机辅助导航，另一侧采用常规技术。手术技术和手术顺序均随机。进行随访研究和进行影像学测量的患者和外科医生对手术类型均不知情。
两组患者在冠状面和矢状面的膝关节假体对线方面存在显著差异。常规组中有 9 个（28%）膝关节假体，与计算机导航组无膝关节假体相比，在冠状面偏离机械轴>3°。常规组数据的变异系数是计算机导航组的三倍。两组股骨组件的旋转角度无显著差异。两组术后 6 个月的美国特种外科医院（HSS）评分均较术前显著提高。
计算机辅助导航始终提供 3°以内的冠状面对线，明显优于常规全膝关节置换术的对线。
