Xu Zhihong, Chen Dongyang, Shi Dongquan, Dai Jin, Jiang Qing
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014 Sep;28(9):1066-71.
To evaluate the value of total knee arthroplasty (TKA) with computer navigation by comparing with conventional TKA.
Between May 2010 and December 2011, 45 patients underwent primary unilateral TKA, and the clinical data were retrospectively analyzed. Of 45 patients, 22 cases were treated with TKA with computer navigation (group A), 23 cases with the conventional TKA (group B). There was no significant difference in gender, age, body mass index, side, cause of disease, disease duration, preoperative range of motion (ROM) of the knee, and preoperative Hospital for Special Surgery (HSS) score between 2 groups (P > 0.05). The operation time, intraoperative blood loss, incidence of patellar retinacular release, complication, and drainage volume were compared. The prosthesis loosening, postoperative HSS score, and ROM of the knee were also compared.
No difference was found in the incidence of patellar retinacular release during TKA, and it was 13.6% (3/22) in group A and was 4.3% (1/23) in group B, showing no significant difference (χ2 = 1.198, P = 0.346). The operation time of group A was significantly longer than that of group B (t = 7.557, P = 0.000). There was no significant difference in intraoperative blood loss during TKA between 2 groups (t = -0.295, P = 0.769), while the drainage volume of group A was significantly less than that of group B (t = -2.419, P = 0.020). Incomplete fracture during TKA and acute infection occurred at 8 days after TKA in 1 case of group A respectively, while no fracture or infection was found in group B, showing significant difference (Z = -0.509, P = 0.000). The patients of 2 groups were followed up 27-46 months. No significant difference in valgus and varus of knee, and malalignment of the femoral and tibial prosthesis was found (P > 0.05). There was no significant difference in HSS score and ROM of the knee at last follow-up between 2 groups (P > 0.05). No prosthesis loosening was found in 2 groups.
TKA with computer navigation has similar results to conventional TKA in the mechanical alignment, but it obviously prolongs operation time. It may also increase the incidence of infection and tractor pin related fracture.
通过与传统全膝关节置换术（TKA）对比，评估计算机导航下全膝关节置换术的价值。
回顾性分析2010年5月至2011年12月间45例行初次单侧TKA患者的临床资料。45例患者中，22例采用计算机导航下TKA治疗（A组），23例采用传统TKA治疗（B组）。两组患者在性别、年龄、体重指数、手术侧别、病因、病程、术前膝关节活动范围（ROM）及术前特殊外科医院（HSS）评分方面差异均无统计学意义（P>0.05）。比较两组手术时间、术中出血量、髌腱膜松解发生率、并发症及引流量。同时比较假体松动情况、术后HSS评分及膝关节ROM。
TKA术中髌腱膜松解发生率两组间差异无统计学意义，A组为13.6%（3/22），B组为4.3%（1/23），差异无统计学意义（χ2 = 1.198，P = 0.346）。A组手术时间显著长于B组（t = 7.557，P = 0.000）。两组TKA术中出血量差异无统计学意义（t = -0.295，P = 0.769），而A组引流量显著少于B组（t = -2.419，P = 0.020）。A组1例患者TKA术中发生不完全骨折，术后8天发生急性感染，B组未发现骨折或感染，差异有统计学意义（Z = -0.509，P = 0.000）。两组患者随访27 - z46个月。膝关节内外翻及股骨和胫骨假体排列不齐差异无统计学意义（P>0.05）。末次随访时两组膝关节HSS评分及ROM差异无统计学意义（P>0.05）。两组均未发现假体松动。
计算机导航下TKA在机械对线方面与传统TKA结果相似，但明显延长手术时间，还可能增加感染及牵引针相关骨折的发生率。
