Shetty Gautam M, Mullaji Arun B, Bhayde Sagar, Lingaraju A P
Department of Orthopaedic Surgery, Breach Candy Hospital, Mumbai, India.
Department of Orthopaedic Surgery, Breach Candy Hospital, Mumbai, India.
Knee. 2014 Aug;21(4):862-5. doi: 10.1016/j.knee.2014.04.004. Epub 2014 Apr 16.
PURPOSE: This retrospective study aimed to determine if computer navigation provides consistent accuracy for limb and component alignment during TKA irrespective of body mass index (BMI) by comparing limb and component alignment and the outlier rates in obese versus non-obese individuals undergoing computer-assisted TKA. METHODS: Six hundred and thirty-five computer assisted total knee arthroplasties (TKAs) performed in non-obese individuals (BMI<30 kg/m(2)) were compared with 520 computer-assisted TKAs in obese individuals (BMI ≥ 30 kg/m(2)) for postoperative limb and component alignment using full length standing hip-to-ankle radiographs. RESULTS: No significant difference in postoperative limb alignment (179.7° ± 1.7° vs 179.6° ± 1.8°), coronal femoral (90.2° ± 1.6° vs 89.8° ± 1.9°) and tibial component (90.2° ± 1.6° vs 90.3° ± 1.7°) alignment and outlier rates (6.2% vs 7.5%) was found between non-obese and obese individuals. Similarly, alignment and the outlier rates were similar when non-obese individuals and a subgroup of morbidly obese individuals (BMI >40 kg/m(2)) were compared. CONCLUSIONS: Computer navigation can achieve excellent limb and component alignment irrespective of a patient's BMI. Although obesity may not be an indication per se for using computer navigation during TKA, it will help achieve consistently accurate limb and component alignment in obese patients. LEVEL OF EVIDENCE: Level II.
目的:这项回顾性研究旨在通过比较接受计算机辅助全膝关节置换术(TKA)的肥胖与非肥胖个体的肢体和假体对线以及异常值率,确定计算机导航在TKA期间是否能为肢体和假体对线提供一致的准确性,而不受体重指数(BMI)的影响。 方法:使用全长站立位髋至踝关节X线片,对635例在非肥胖个体(BMI<30 kg/m²)中进行的计算机辅助全膝关节置换术(TKA)与520例在肥胖个体(BMI≥30 kg/m²)中进行的计算机辅助TKA的术后肢体和假体对线进行比较。 结果:非肥胖和肥胖个体之间在术后肢体对线(179.7°±1.7°对179.6°±1.8°)、冠状面股骨假体对线(90.2°±1.6°对89.8°±1.9°)、胫骨假体对线(90.2°±1.6°对90.3°±1.7°)和异常值率(6.2%对7.5%)方面未发现显著差异。同样,当比较非肥胖个体和病态肥胖个体亚组(BMI>40 kg/m²)时,对线和异常值率也相似。 结论:无论患者的BMI如何,计算机导航都能实现出色的肢体和假体对线。虽然肥胖本身可能不是TKA期间使用计算机导航的指征,但它将有助于在肥胖患者中实现始终准确的肢体和假体对线。 证据水平:二级。
Knee Surg Sports Traumatol Arthrosc. 2008-3
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