Hernandez-Vaquero D, Suarez-Vazquez A, Iglesias-Fernandez S
Department of Orthopaedic Surgery. School of Medicine, University of Oviedo and Hospital St Agustin. Aviles, Asturias, Spain.
Acta Chir Orthop Traumatol Cech. 2012;79(4):331-24.
The use of navigation applied to total knee arthroplasty in knees with femoral hardware retained has not been studied.
We use navigation in six patients to implant a total knee arthroplasty while retaining the femoral hardware. The retained materials were screws in two cases, diaphyseal plates in another two, intramedullary nails in one and supracondylar tube/plate in another one. Preoperative knee scores were within the 46-66 range, whereas the functional scores were within 40-68. The coronal deformity varied between 30° varus and 5° valgus.
The final femoral mechanical axis was between 2° valgus and 3° varus; the axis of the limb was between 4° valgus and 3° varus. Knee scores improved in all cases, with scores between 75 and 90 points (p = 0.028); functional scores were between 64 and 90 points (p = 0.043).The final range of mobility was within the 70°-110° range, with a slight improvement over the preoperative status (p = 0.042). No complications have arisen throughout the follow-up (mean 16 months).
The use of navigation constitutes a good option in the treatment with total arthroplasties for patients with femoral hardware retained.
尚未对导航技术应用于保留股骨内固定装置的全膝关节置换术进行研究。
我们对6例保留股骨内固定装置的患者使用导航技术进行全膝关节置换术。保留的内固定材料中，2例为螺钉，另2例为骨干钢板，1例为髓内钉，1例为髁上管/钢板。术前膝关节评分在46 - 66分之间，功能评分在40 - 68分之间。冠状面畸形在30°内翻至5°外翻之间。
最终股骨机械轴在2°外翻至3°内翻之间；肢体轴线在4°外翻至3°内翻之间。所有病例膝关节评分均有改善，评分在75 - 90分之间（p = 0.028）；功能评分在64 - 90分之间（p = 0.043）。最终活动范围在70° - 110°之间，较术前状态略有改善（p = 0.042）。随访期间（平均16个月）未出现并发症。
对于保留股骨内固定装置的患者，在全关节置换治疗中使用导航技术是一个不错的选择。
