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计算机辅助全膝关节置换术前的CT测量并不能改善股骨组件的旋转定位。

CT measurements prior to computer-assisted total knee arthroplasty do not improve rotational placement of the femoral component.

作者信息

de Ladoucette A

机构信息

Clinique de l'Union, Boulevard Ratalens, 31240, Saint Jean, France.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2012 Dec;20(12):2471-5. doi: 10.1007/s00167-012-1909-6.

Abstract

PURPOSE

The aim of this study is to determine whether computer-assisted surgery (CAS) can gain more precision by utilizing information from pre-operative computed tomography (CT).

METHODS

Sixty-five patients undergoing total knee arthroplasty in 2008 were included. On pre- and post-operative CT, epicondylar and posterior condylar lines were drawn and the posterior condylar angle between these two lines measured. During the surgery, epicondylar and posterior condylar lines were also registered before and after CAS-guided cuts were made. CAS was used to fix the orientation of the cutting guide on the distal femur at 3° of external rotation from the posterior condylar line.

RESULTS

There was no correlation between CT measurements and CAS measurements. All orientations of the lines (relative to the horizontal) and angles measured using CT were significantly different (p < 0.05).

CONCLUSION

No relationship was found between pre-operative CT measurements and peri-operative CAS measurements used to orient the femoral component. Data obtained from CT cannot be used peri-operatively with CAS to improve rotational setting of the femoral component.

LEVEL OF EVIDENCE

Therapeutic study, Level II.

摘要

目的

本研究旨在确定计算机辅助手术(CAS)能否通过利用术前计算机断层扫描(CT)信息获得更高的精度。

方法

纳入2008年接受全膝关节置换术的65例患者。在术前和术后CT上,绘制髁上和髁后线,并测量这两条线之间的髁后角。在手术过程中,在进行计算机辅助手术(CAS)引导的截骨前后,也记录髁上和髁后线。计算机辅助手术(CAS)用于将股骨远端截骨导向器的方向固定在相对于髁后线外旋3°处。

结果

CT测量值与计算机辅助手术(CAS)测量值之间无相关性。使用CT测量的所有线的方向(相对于水平)和角度均有显著差异(p<0.05)。

结论

术前CT测量值与用于确定股骨假体方向的术中计算机辅助手术(CAS)测量值之间未发现相关性。从CT获得的数据不能在术中与计算机辅助手术(CAS)一起用于改善股骨假体的旋转定位。

证据水平

治疗性研究,二级。

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