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计算机辅助导航在初次和翻修手术中对于模块化旋转铰链膝关节置换术均有益处。

Computer-assisted navigation is beneficial both in primary and revision surgery with modular rotating-hinge knee arthroplasty.

作者信息

Ochs Björn G, Schreiner Anna J, de Zwart Peter M, Stöckle Ulrich, Gonser Christoph Emanuel

机构信息

BG Trauma Centre, Eberhard Karls University of Tübingen, Schnarrenbergstraße 95, 72076, Tübingen, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2016 Jan;24(1):64-73. doi: 10.1007/s00167-014-3316-7. Epub 2014 Sep 20.

Abstract

PURPOSE

The objective of the present study was to explore the effect of navigation on the reconstruction of the mechanical leg axis, implant positioning and the restoration of the joint line in hinged knee arthroplasty in vivo. We present the first 1- to 3-year clinical and radiological results following computer-navigated implantation of the EnduRo modular rotating-hinge knee arthroplasty system (Aesculap AG, Tuttlingen, Germany) as a primary or revision implant.

METHODS

Thirty-one patients were analysed retrospectively. Indication was revision surgery in 18 patients and complex primary surgery in 13. The clinical and radiological results of 31 patients with a minimum follow-up of 12 months (mean 22.2 ± 6.2 months) were recorded. Age at follow-up was 55.2 ± 9.9 years.

RESULTS

The absolute varus-valgus deviation from the neutral mechanical leg axis was determined at 5.1° ± 5.1° preoperatively and 2.1° ± 1.4° postoperatively. No intraoperative complications or problems with the navigation system were observed. At latest follow-up, no component loosening was detected. Based on the Knee Society Score, a knee score of 64.9 ± 17.7 points and a function score of 67.2 ± 27.3 points were achieved.

CONCLUSIONS

Encouraging short-term clinical and radiological results with the computer-navigated implantation of the modular rotating-hinge EnduRo knee arthroplasty system were found in both primary and revision surgery. The navigation facilitated the reconstruction of the leg axis, implant positioning and the restoration of the joint line.

LEVEL OF EVIDENCE

IV.

摘要

目的

本研究的目的是探讨导航技术在体内铰链式膝关节置换术中对机械腿轴重建、植入物定位及关节线恢复的影响。我们展示了采用EnduRo模块化旋转铰链膝关节置换系统(德国图特林根市蛇牌股份公司)进行计算机导航植入作为初次或翻修植入物后的首个1至3年临床及影像学结果。

方法

对31例患者进行回顾性分析。其中18例为翻修手术指征,13例为复杂初次手术指征。记录了31例患者至少随访12个月(平均22.2±6.2个月)的临床及影像学结果。随访时年龄为55.2±9.9岁。

结果

术前机械腿轴中立位的绝对内外翻偏差为5.1°±5.1°,术后为2.1°±1.4°。未观察到术中并发症或导航系统问题。在最近一次随访时,未检测到组件松动。根据膝关节协会评分,膝关节评分为64.9±17.7分,功能评分为67.2±27.3分。

结论

在初次和翻修手术中,采用计算机导航植入模块化旋转铰链EnduRo膝关节置换系统均获得了令人鼓舞的短期临床及影像学结果。导航技术有助于腿轴重建、植入物定位及关节线恢复。

证据等级

IV级。

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