计算机辅助手术。其在不同程度术前畸形中的作用。
Computer assisted surgery. Its usefulness in different levels of pre-operative deformities.
作者信息
Benavente P, López Orosa C, Oteo Maldonado J A, Orois Codesal A, García Lázaro F J
机构信息
Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.
Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.
出版信息
Rev Esp Cir Ortop Traumatol. 2015 Jul-Aug;59(4):245-53. doi: 10.1016/j.recot.2014.10.002. Epub 2014 Dec 4.
OBJECTIVE
To compare the results obtained with computer assisted surgery with conventional techniques and evaluate the influence of navigation at different levels of preoperative deformity.
MATERIAL AL METHOD
A retrospective study was conducted on 100 cases with primary total knee arthroplasty performed with conventional or computer assisted surgery. A comparison was made of the post-operative mechanical axis of the lower limb between both groups and in terms of pre-operative deformity.
RESULTS
Optimal alignment is most often obtained by using the navigation system (62%) than by a conventional technique (36%). Patients with deformities under 10° varus showed a mean post-operative alignment within the optimal range (0±3° deviation from the neutral mechanical axis), while those with more than 15° of varus show an alignment out of range, regardless of the technique used (p=.002). In those with a deformity of between 10 and 15° of pre-operative varus alignment, values were found closer to the neutral axis in the navigation group (178.7°) than in the conventional technique (175.5°), although these differences are not statistically significant (p=.127).
CONCLUSION
Post-operative alignment obtained with navigation is better than with the conventional technique, with a smaller percentage of cases out of range, and greater accuracy in placing implants. A potential benefit was observed in navigation for cases with deformities of between 10 and 15° of varus.
目的
比较计算机辅助手术与传统技术的结果,并评估导航在不同术前畸形程度下的影响。
材料与方法
对100例行初次全膝关节置换术的患者进行回顾性研究,这些患者采用传统手术或计算机辅助手术。比较两组患者术后下肢的机械轴以及术前畸形情况。
结果
使用导航系统最常获得最佳对线(62%),而传统技术为36%。内翻畸形小于10°的患者术后平均对线在最佳范围内(与中立机械轴偏差0±3°),而内翻超过15°的患者,无论采用何种技术,对线均超出范围(p = 0.002)。术前内翻对线在10至15°之间的患者,导航组的数值(178.7°)比传统技术组(175.5°)更接近中立轴,尽管这些差异无统计学意义(p = 0.127)。
结论
导航获得的术后对线优于传统技术,超出范围的病例百分比更小,植入物放置的准确性更高。对于内翻畸形在10至15°之间的病例,导航显示出潜在益处。