Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "Sapienza", Via Grottarossa, 1035, Rome, RM, Italy.
Knee Surg Sports Traumatol Arthrosc. 2013 Oct;21(10):2194-9. doi: 10.1007/s00167-012-2098-z. Epub 2012 Jun 27.
The aim of this study is to evaluate the accuracy of a patient-specific instrumentation (PSI) as assessed by the intraoperative use of knee navigation software during the surgical procedure.
Fifteen patients with primary gonarthrosis were selected for unilateral total knee arthroplasty. The first three patients were excluded from this study, as they were considered to be a warm up to set-up the procedure. All patients were operated on with a cemented posterior-stabilised prosthesis cruciate ligament-sacrificing by the same surgeon using the patient matched cutting jigs. The size of the implant, level of resection, and alignment in the coronal and sagittal planes were evaluated. An unsatisfactory result was considered an error ≥2° in both planes for each component as a possible error of 4° could result in aggravation.
On the coronal plane the mean deviation of the tibial guide from the ideal alignment was 1.2 ± 1.5 (range 0-5°) and in the sagittal plane was 3.8 ± 2.4 (range 0-7.5°). On the coronal plane the mean deviation of the femoral guide from the ideal alignment was 1.2 ± 0.6 and in the sagittal was 3.7 ± 2.
On the basis of this preliminary experience the PSI system based only on data acquisition with A-P radiograms and RMN cannot be defined as accurate. In cases of the use of the custom made cutting jigs it is recommended to perform an accurate control of the alignment before making the cuts, for any step of the procedure.
II.
本研究旨在评估术中使用膝关节导航软件辅助使用患者特定型手术器械（PSI）的准确性。
选择 15 例原发性膝关节骨关节炎患者行单侧全膝关节置换术。前 3 例患者被排除在本研究之外，因为他们被认为是为了设置手术程序而进行的热身。所有患者均由同一位外科医生使用患者匹配的截骨导向器，采用骨水泥固定后稳定型假体行后交叉韧带保留型全膝关节置换术。评估植入物的大小、截骨平面、冠状面和矢状面的对线情况。如果每个组件的两个平面的误差均≥2°，则认为结果不满意，因为可能会导致 4°的误差加重。
在冠状面，胫骨导向器与理想对线的平均偏差为 1.2±1.5°（范围 0-5°），在矢状面为 3.8±2.4°（范围 0-7.5°）。在冠状面，股骨导向器与理想对线的平均偏差为 1.2±0.6°，在矢状面为 3.7±2.
根据这初步经验，仅基于前后位 X 线片和 MRI 数据采集的 PSI 系统不能被定义为准确。在使用定制截骨导向器的情况下，建议在进行任何步骤之前，对所有步骤进行准确的对线控制。
II 级。
