Zhang Zhenxiang, Zhu Wei, Zhu Lixian, Du Yaqing
Orthopedic Department, The Affiliated Taizhou People's Hospital of Nantong University, Yingchun Road, Taizhou, 225300, Jiangsu, China.
Knee Surg Sports Traumatol Arthrosc. 2016 Nov;24(11):3419-3424. doi: 10.1007/s00167-014-3456-9. Epub 2014 Nov 26.
Variety of clinical trials have been published comparing the alignment of MICA-UKA with MI-UKA. However, to the best of our knowledge, no published study has showed whether radiological alignment by MICA-UKA has influence on the clinical results. The present study was conducted to compare the short-term results of MICA-UKA with MI-UKA. It was hypothesized that better alignment as well as clinical results was achieved by MICA-UKA as compared to MI-UKA.
The clinical and radiological results of 87 subjects who underwent primary UKA using either minimally invasive and computer-assisted technique (45 patients Group A) or minimally invasive technique (42 patients, Group B) were reported. Knee Society scores (KSSs), Knee Society functional scores (KSFSs), range of motion (ROM), and radiographic results were assessed and reported preoperatively and at 24-month follow-up. Total blood loss, operative time, and length of skin incision were compared.
The accuracy of the implantations in relation to the coronal mechanical axis in Group A was significantly superior to that of Group B (P = 0.033). The femoral rotational profile revealed the prosthesis in Group A that was implanted with significantly less internal rotation than Group B (P = 0.025). Clinical results, with regard to ROMs and KSSs, as well as KSFSs were equally good in both the groups. The average blood loss in patients of Group A was significantly reduced as compared to patients of Group B. No significant difference was detected in terms of operative time or length of skin incision.
It is suggested that MICA-UKA improves the implant alignment without increasing clinical results versus MI-UKA. We advocate that computer navigation should be considered when minimally invasive unicompartmental knee arthroplasty is performed.
Therapeutic study, Level II.
已发表了多种比较微创计算机辅助单髁膝关节置换术(MICA-UKA)与微创单髁膝关节置换术(MI-UKA)对线情况的临床试验。然而,据我们所知,尚无已发表的研究表明MICA-UKA的影像学对线是否会影响临床结果。本研究旨在比较MICA-UKA与MI-UKA的短期结果。研究假设是,与MI-UKA相比,MICA-UKA能实现更好的对线以及临床结果。
报告了87例行初次单髁膝关节置换术患者的临床和影像学结果,这些患者采用了微创和计算机辅助技术(45例患者,A组)或微创技术(42例患者,B组)。术前及术后24个月随访时评估并报告膝关节协会评分(KSS)、膝关节协会功能评分(KSFS)、活动范围(ROM)及影像学结果。比较总失血量、手术时间及皮肤切口长度。
A组假体植入相对于冠状面机械轴的准确性显著优于B组(P = 0.033)。股骨旋转情况显示,A组植入的假体相对于B组内旋明显更少(P = 0.025)。两组在ROM、KSS及KSFS方面的临床结果同样良好。与B组患者相比,A组患者的平均失血量显著减少。手术时间及皮肤切口长度方面未检测到显著差异。
提示与MI-UKA相比,MICA-UKA在不增加临床结果的情况下改善了假体对线。我们提倡在进行微创单髁膝关节置换术时应考虑计算机导航。
治疗性研究,II级。