Barke Samuel, Musanhu Ed, Busch Constant, Stafford Giles, Field Richard
South West London Elective Orthopaedic Centre, Dorking Road, Epsom, Surrey, UK.
Acta Orthop Belg. 2013 Jun;79(3):307-11.
This study aimed to assess if patient-matched cutting blocks reduce operating time, blood loss and length of stay on top of improving implant alignment and offer operational or economic benefits, as claimed by manufacturers. We retrospectively reviewed patients undergoing TKA using patient matched technology and compared them with patients undergoing TKA using standard instrumentation; all were operated on between September 2010 and June 2012. All procedures were performed by a single surgeon at a single centre using the same implants. We collected data on operating time, length of stay and blood loss and also measured component alignment. Thirty-nine patients underwent TKA using patient-matched technology during the study period. Data was compared with that from 50 patients undergoing TKA using standard instrumentation during the same period. We found no significant difference in operating time, length of stay or blood loss between the two groups. There was also no difference in femoral or tibial component alignment although we did observe that the femorotibial angle of TKAs using patient-matched technology was 0.9 degrees more valgus (183.5 degrees versus 182.6 degrees, p = 0.035). In this study, patient-matched technology did not appear to give any clinical advantages over standard techniques although, equally, it did not appear to show any disadvantages. Further studies are needed to evaluate whether operational or economic benefits may be achieved by adoption of patient matched instrumentation.
本研究旨在评估与患者匹配的截骨模块是否如制造商所宣称的那样，在改善植入物对线的基础上，减少手术时间、失血量和住院时间，并带来操作或经济效益。我们回顾性分析了采用与患者匹配技术进行全膝关节置换术（TKA）的患者，并将他们与采用标准器械进行TKA的患者进行比较；所有患者均在2010年9月至2012年6月期间接受手术。所有手术均由同一中心的同一位外科医生使用相同的植入物进行。我们收集了手术时间、住院时间和失血量的数据，并测量了假体组件的对线情况。在研究期间，39例患者采用了与患者匹配的技术进行TKA。将这些数据与同期50例采用标准器械进行TKA的患者的数据进行比较。我们发现两组患者在手术时间、住院时间或失血量方面没有显著差异。股骨或胫骨假体组件的对线也没有差异，尽管我们确实观察到，采用与患者匹配技术的TKA的股胫角外翻多0.9度（分别为183.5度和182.6度，p = 0.035）。在本研究中，与患者匹配的技术似乎并没有比标准技术带来任何临床优势，同样，它似乎也没有显示出任何劣势。需要进一步的研究来评估采用与患者匹配的器械是否能实现操作或经济效益。
