Fitz W, Jäger S, Rieger J S, Seebach E, Bitsch R G
Department of Orthopaedic Surgery, Brigham and Women's and Brigham Faulkner Hospital, 850 Boylston Street, Chestnut Hill, MA, 02467, USA.
Laboratory of Biomechanics and Implant Research, Department of Orthopaedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstr. 200A, 69118, Heidelberg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2017 Jun;25(6):1712-1719. doi: 10.1007/s00167-015-3836-9. Epub 2015 Oct 24.
The purpose of our study was to compare the accuracy of the rotational position of the femoral component in total knee arthroplasty aligned with patient individualized jigs (PSJ) to a gap balancing technique (GBT).
A consecutive series of 21 osteoarthritic patients were treated with 22 cruciate-retaining total knee prostheses. During surgery, the rotation of the femoral component pinholes was recorded for all knees using PSJ and GBT and transferred to computer tomograms (CT). The rotational differences between PSJ and GBT relative to the transepicondylar axis were analysed.
The medium rotation of the femoral component pinholes was 1.3° ± 5.1° (min = -6.3°; max = 14.4°) for PSJ and 0.1 ± 1.4° (min = -1.6°; max = 3.4°) for GBT. Outliers of more than 3° were found more frequently with PSJ in 12 cases but only in one for GBT.
Based on our study, we would not recommend relying intra-operatively solely on the CT-based PSJ without the option to adjust or control femoral rotation.
II.
我们研究的目的是比较全膝关节置换术中使用患者个体化夹具（PSJ）与间隙平衡技术（GBT）时股骨组件旋转位置的准确性。
连续纳入21例骨关节炎患者，使用22个保留交叉韧带的全膝关节假体进行治疗。手术过程中，使用PSJ和GBT记录所有膝关节股骨组件针孔的旋转情况，并转移至计算机断层扫描（CT）图像上。分析PSJ和GBT相对于经髁轴的旋转差异。
PSJ组股骨组件针孔的平均旋转角度为1.3°±5.1°（最小值=-6.3°；最大值=14.4°），GBT组为0.1°±1.4°（最小值=-1.6°；最大值=3.4°）。12例患者中，PSJ组出现超过3°的异常值的情况比GBT组更频繁，GBT组仅1例出现这种情况。
基于我们的研究，我们不建议在术中仅依靠基于CT的PSJ而不具备调整或控制股骨旋转的选项。
II级。
