Department of Orthopaedic Surgery, University Hospital of Munich, Ludwig-Maximilians-University, Campus Großhadern, Marchioninistr. 15, 81377 Munich, Germany.
Arch Orthop Trauma Surg. 2012 Feb;132(2):281-8. doi: 10.1007/s00402-011-1404-4. Epub 2011 Oct 8.
Minimally invasive implantation of unicompartmental knee prostheses can shorten rehabilitation time and lead to better functional results than conventional implantation. Exact positioning of the implant should be achieved, as this is a factor for the long-term survival of the prosthesis, although malpositioning can result due to the poor intraoperative view when using the minimally invasive approach. Navigation of the unicompartmental prosthesis could lead to a better implant positioning without losing the advantages of a minimally invasive approach.
The same unicondylar knee prosthesis was implanted in a total of 40 patients, of whom 20 were implanted using navigation (kinematic navigation) and 20 using a conventional technique. The operating time was assessed in both groups. The orientation of the tibial and femoral implants was assessed radiologically postoperatively. We analysed these results according to the optimal positioning range proposed by the manufacturer. Furthermore, we examined the clinical results with the knee society score (KSS).
A good positioning of the prosthesis was observed in both techniques with only 11% of the radiologic measurements out of the proposed optimal range in each group. The operating time was significantly longer in the navigation group (17 min). The KSS did not differ between both groups at a follow-up of 16 resp. 18 months (navigated group: 184 points, conventional group: 178 points).
Navigation did not lead to a better positioning of the prosthesis than the conventional method and the operating time was longer. The clinical results were similar in both groups. The navigation may be a useful help for surgeons performing less unicompartmental knee arthroplasty using a minimally invasive approach.
微创单髁膝关节假体植入术可以缩短康复时间，并带来比传统植入术更好的功能结果。为了假体的长期生存，应实现植入物的精确定位，尽管由于微创入路术中视野不佳，可能会导致定位不当。单髁假体的导航可以实现更好的植入物定位，而不会失去微创入路的优势。
共对 40 例患者进行了相同的单髁膝关节假体植入，其中 20 例采用导航（运动学导航），20 例采用传统技术。评估两组的手术时间。术后评估胫骨和股骨植入物的方向。我们根据制造商提出的最佳定位范围分析了这些结果。此外，我们用膝关节学会评分（KSS）评估了临床结果。
两种技术均观察到假体的良好定位，每组只有 11%的放射学测量值超出建议的最佳范围。导航组的手术时间明显更长（17 分钟）。随访 16 个月和 18 个月时，两组的 KSS 评分无差异（导航组：184 分，传统组：178 分）。
导航并没有比传统方法更能使假体定位更好，而且手术时间更长。两组的临床结果相似。导航可能对使用微创入路进行较少单髁膝关节置换术的外科医生有用。
