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基于CT的患者个体化器械全膝关节置换术后的结果

Outcomes following total knee arthroplasty with CT-based patient-specific instrumentation.

作者信息

Zhu Meng, Chen Jerry Yongqiang, Chong Hwei Chi, Yew Andy Khye Soon, Foo Leon Siang Shen, Chia Shi-Lu, Lo Ngai Nung, Yeo Seng Jin

机构信息

Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore.

Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Singapore, 169865, Singapore.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2017 Aug;25(8):2567-2572. doi: 10.1007/s00167-015-3803-5. Epub 2015 Sep 26.

Abstract

PURPOSE

A 24-month prospective follow-up study was carried out to compare perioperative clinical outcomes, radiographic limb alignment, component positioning, as well as functional outcomes following total knee arthroplasty (TKA) between patient-specific instrumentation (PSI) and conventional instrumentation (CI).

METHODS

Ninety consecutive patients, satisfying the inclusion and exclusion criteria, were scheduled to undergo TKA with either PSI or CI. A CT-based PSI was used in this study, and a senior surgeon performed all surgeries. Patients were clinically and functionally assessed preoperatively, 6 and 24 months post-operatively. Perioperative outcomes were also analysed, including operating time, haemoglobin loss, the need for blood transfusion, length of hospitalisation, and radiographic features.

RESULTS

At 24-month follow-up, clinical and functional outcomes were comparable between the two groups. PSI performed no better than CI in restoring lower limb mechanical alignment or improving component positioning. There were no differences in operating time, haemoglobin loss, transfusion rate, or length of hospitalisation between PSI and CI.

CONCLUSION

No significant clinical benefit could be demonstrated in using PSI over CI after 24 months, and routine use of PSI is not recommended in non-complicated TKA.

LEVEL OF EVIDENCE

II.

摘要

目的

开展一项为期24个月的前瞻性随访研究,以比较患者特异性器械(PSI)和传统器械(CI)在全膝关节置换术(TKA)后的围手术期临床结果、影像学肢体对线、假体位置以及功能结果。

方法

90例符合纳入和排除标准的连续患者计划接受使用PSI或CI的TKA手术。本研究使用基于CT的PSI,所有手术均由一名资深外科医生进行。在术前、术后6个月和24个月对患者进行临床和功能评估。还分析了围手术期结果,包括手术时间、血红蛋白丢失、输血需求、住院时间和影像学特征。

结果

在24个月的随访中,两组的临床和功能结果相当。在恢复下肢机械对线或改善假体位置方面,PSI并不比CI表现更好。PSI和CI在手术时间、血红蛋白丢失、输血率或住院时间方面没有差异。

结论

24个月后,使用PSI并不比CI有显著的临床益处,不建议在非复杂TKA中常规使用PSI。

证据级别

II级。

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