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针对关节外畸形患者的导航辅助全膝关节置换术。

Navigation-assisted total knee arthroplasty for patients with extra-articular deformity.

作者信息

Rhee Seung Joon, Seo Chang Hyo, Suh Jeung Tak

机构信息

Department of Orthopedic Surgery, Pusan National University Hospital, Busan, Korea.

出版信息

Knee Surg Relat Res. 2013 Dec;25(4):194-201. doi: 10.5792/ksrr.2013.25.4.194. Epub 2013 Nov 29.

DOI:10.5792/ksrr.2013.25.4.194
PMID:24368997
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3867612/
Abstract

PURPOSE

Since the existence of an extra-articular deformity seriously alters the normal geometry and kinetics around the knee joint, difficulties are often encountered in total knee arthroplasty (TKA) using a standard surgical technique. The purpose of this study was to evaluate the usefulness of surgical navigation system as a treatment option for osteoarthritic knees with extra-articular deformity.

MATERIALS AND METHODS

The authors retrospectively reviewed medical records of the patients who underwent primary TKA between 2007 and 2012. Knees with preoperative radiography showing an angular deformity within the region from the middle third of the femur to the middle third of the tibia in the ipsilateral limb of the arthritic knees were considered as cases having extra-articular deformity. Thirteen knees of the 13 patients were found to have undergone TKA using a navigation system for osteoarthritis with ipsilateral extra-articular deformity. The hip-knee-ankle angle, Knee Society score (KSS), and range of motion were measured before and after the operation to evaluate the improvement.

RESULTS

The mean hip-knee-ankle angle in the coronal plane was improved to 0.2°±4.5° in valgus alignment postoperatively. The KSS was improved to 89.6±4.6 points postoperatively at the last follow-up, with over 90% of good and excellent results. The range of motion was improved to 118.5°±10.5° postoperatively.

CONCLUSIONS

Navigation-assisted TKA is a good treatment option of osteoarthritic knees with extra-articular deformity.

摘要

目的

由于关节外畸形的存在会严重改变膝关节周围的正常几何结构和动力学，采用标准手术技术进行全膝关节置换术（TKA）时常常会遇到困难。本研究的目的是评估手术导航系统作为治疗伴有关节外畸形的骨关节炎膝关节的一种治疗选择的有效性。

材料与方法

作者回顾性分析了2007年至2012年间接受初次TKA的患者的病历。术前X线片显示患侧肢体中，在股骨中三分之一至胫骨中三分之一区域内存在角状畸形的膝关节被视为伴有关节外畸形的病例。13例患者的13个膝关节采用导航系统进行了伴有同侧关节外畸形的骨关节炎TKA手术。在手术前后测量髋-膝-踝角、膝关节协会评分（KSS）和活动范围，以评估改善情况。

结果

术后冠状面平均髋-膝-踝角在外翻对线时改善至0.2°±4.5°。在最后一次随访时，KSS术后改善至89.6±4.6分，其中超过90%为优良结果。术后活动范围改善至118.5°±10.5°。

结论

导航辅助TKA是治疗伴有关节外畸形的骨关节炎膝关节的一种良好治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/023e53b1f7d5/ksrr-25-194-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/340a4e8bb646/ksrr-25-194-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/f9df8e923a93/ksrr-25-194-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/7c61a230b2e4/ksrr-25-194-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/9189034536b4/ksrr-25-194-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/599f4b4bdb65/ksrr-25-194-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/023e53b1f7d5/ksrr-25-194-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/340a4e8bb646/ksrr-25-194-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/f9df8e923a93/ksrr-25-194-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/7c61a230b2e4/ksrr-25-194-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/9189034536b4/ksrr-25-194-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/599f4b4bdb65/ksrr-25-194-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9945/3867612/023e53b1f7d5/ksrr-25-194-g006.jpg

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