Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China.
Chin Med J (Engl). 2012 Jan;125(2):236-43.
Proper rotational alignment during total knee arthroplasty (TKA) is important for adequate postoperative patellofemoral and tibiofemoral kinematics, as well as for achieving balanced flexion space at 90. The effects of computer navigation-assisted total knee replacement and conventional total knee arthroplasty on rotational alignment, mechanical axis, component position and clinical outcomes were compared.
Two methods were used in 82 patients and the rotation of the femoral and tibial components in the transverse plane, the combined rotation of the two components, the mismatch between them, and the mechanical axis of the lower limb were analyzed. All of these parameters were measured from postoperative radiographs and computed tomography images. Functional outcomes were compared at 6 weeks and 6 months postoperatively.
Significant differences were found between the two techniques (P < 0.05) in the following parameters: average rotation of the femoral component ((1.51 ± 3.55)° vs. (-0.63 ± 3.04)°); combined rotation of the femoral and tibial components (2.85 ± 4.07)° vs. (0.28 ± 3.43)°); and mismatch between the femoral and tibial components ((1.44 ± 4.55)° vs. (-0.43 ± 2.86)°). Differences in the rotation of the tibial component were not statistically significant. The prevalence of outliers (malalignment > ± 3° internal/external rotation) of the femoral component (31.7% vs. 12.5%) and the tibial component (36.6% vs. 15%) were significantly reduced when the navigation system was used (P < 0.05). In addition, while patients in the navigation group had significantly better mechanical axis and functional outcomes at 6 weeks after surgery (P < 0.05), there was no significant difference between the two groups (P > 0.05) with respect to functional outcomes at 6 months.
The navigation system exhibited higher accuracy than the conventional technique in the transverse and coronal plane, and provided better early functional outcomes.
全膝关节置换术（TKA）中正确的旋转对线对于获得良好的髌股和胫股关节运动学以及获得 90°时平衡的屈曲间隙非常重要。比较了计算机导航辅助全膝关节置换术和传统全膝关节置换术对旋转对线、机械轴、假体位置和临床结果的影响。
82 例患者分别采用两种方法，分析了股骨和胫骨在横平面上的旋转、两组件的联合旋转、两者之间的不匹配以及下肢的机械轴。所有这些参数均通过术后 X 线片和 CT 图像测量。比较术后 6 周和 6 个月的功能结果。
两种技术（P<0.05）在以下参数方面存在显著差异：股骨组件的平均旋转（（1.51±3.55）° vs.（-0.63±3.04）°）；股骨和胫骨组件的联合旋转（2.85±4.07）° vs.（0.28±3.43）°）；股骨和胫骨组件之间的不匹配（（1.44±4.55）° vs.（-0.43±2.86）°）。胫骨组件的旋转差异无统计学意义。当使用导航系统时，股骨组件（31.7% vs. 12.5%）和胫骨组件（36.6% vs. 15%）的外旋（旋转对线大于±3°）发生率显著降低（P<0.05）。此外，导航组患者术后 6 周的机械轴和功能结果明显优于常规组（P<0.05），但两组术后 6 个月的功能结果无明显差异（P>0.05）。
与传统技术相比，导航系统在横平面和冠状面具有更高的准确性，并提供了更好的早期功能结果。
