Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th St., New York, NY 10021, USA.
Knee Surg Sports Traumatol Arthrosc. 2012 Sep;20(9):1736-41. doi: 10.1007/s00167-011-1752-1. Epub 2011 Nov 25.
Computer navigation increases accuracy and precision of component alignment in total knee arthroplasty (TKA) compared to the manual technique, but is often associated with increases in surgical time. In a previous cadaver study, we demonstrated a significant improvement in guide positioning precision, final bone cut precision, and procedure length when using adjustable cutting blocks (ACB) compared to conventional cutting blocks (CCB) in computer-navigated TKA. The aim of this study was to evaluate the use of ACB in vivo.
We radiographically compared component alignment and mechanical leg alignment, as well as tourniquet time, in 94 patients who underwent TKA using either ACB (N = 30) or CCB (N = 64).
Postoperative mechanical alignment variability was significantly less in the ACB group (SD = 1.7°) than in the CCB group (SD = 2.7°). Tourniquet time was significantly reduced by 14.8 min in the ACB group compared to the CCB. Differences in component alignment were not significant.
ACB for TKA significantly reduced postoperative mechanical alignment variability and tourniquet time compared to conventional navigated instrumentation, while providing equal or better component alignment.
III.
与手动技术相比，计算机导航可提高全膝关节置换术（TKA）中组件对准的准确性和精度，但通常与手术时间的增加有关。在之前的尸体研究中，我们证明了在计算机导航 TKA 中使用可调节截骨块（ACB）与传统截骨块（CCB）相比，在导板定位精度、最终骨切精度和手术时间方面有显著改善。本研究旨在评估 ACB 的体内应用。
我们对 94 例接受 ACB（N=30）或 CCB（N=64）治疗的 TKA 患者进行了影像学比较，比较了组件对齐和机械腿对齐以及止血带时间。
ACB 组术后机械对线的变异性明显小于 CCB 组（SD=1.7°）。ACB 组与 CCB 组相比，止血带时间显著减少了 14.8 分钟。组件对准的差异不显著。
与传统导航器械相比，ACB 可显著降低 TKA 的术后机械对线变异性和止血带时间，同时提供同等或更好的组件对准。
III 级。
