Yoo Ju Hyung, Park Sang Hoon, Han Chang Dong, Oh Hyun Cheol, Park Jun Young, Choi Seung Jin
Department of Orthopedic Surgery, National Health Insurance Service, Ilsan Hospital, Goyang, Korea.
Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2016 Jan;57(1):225-31. doi: 10.3349/ymj.2016.57.1.225.
To identify the accuracy of postoperative implant alignment in minimally invasive surgery total knee arthroplasty (MIS-TKA), based on the degree of varus deformity.
The research examined 627 cases of MIS-TKA from November 2005 to December 2007. The cases were categorized according to the preoperative degree of varus deformity in the knee joint in order to compare the postoperative alignment of the implant: less than 5° varus (Group 1, 351 cases), 5° to less than 10° varus (Group 2, 189 cases), 10° to less than 15° varus (Group 3, 59 cases), and 15° varus or more (Group 4, 28 cases).
On average, the alignment of the tibial implant was 0.2±1.4°, 0.1±1.3°, 0.1±1.6°, and 0.3±1.7° varus, and the tibiofemoral alignment was 5.2±1.9degrees, 4.7±1.9°, 4.9±1.9°, and 5.1±2.0° valgus for Groups 1, 2, 3, and 4, respectively, in the preoperative stage, indicating no difference between the groups (p>0.05). With respect to the accuracy of the tibial implant alignment, 98.1%, 97.6%, 87.5%, and 86.7% of Groups 1, 2, 3, and 4, respectively, had 0±3° varus angulation, demonstrating a reduced level of accuracy in Groups 3 and 4 (p<0.0001). There was no difference in terms of tibiofemoral alignment, with 83.9%, 82.9%, 85.4%, and 86.7% of each group, respectively, showing 6±3° valgus angulation (p>0.05).
Satisfactory component alignment was achieved in minimally invasive surgery in total knee arthroplasty, regardless of the degree of varus deformity.
基于内翻畸形程度,确定微创全膝关节置换术(MIS-TKA)中术后植入物对线的准确性。
本研究对2005年11月至2007年12月期间的627例MIS-TKA病例进行了检查。根据术前膝关节内翻畸形程度对病例进行分类,以比较植入物的术后对线情况:内翻小于5°(第1组,351例),5°至小于10°内翻(第2组,189例),10°至小于15°内翻(第3组,59例),以及15°及以上内翻(第4组,28例)。
术前阶段,第1、2、3和4组胫骨植入物的对线平均内翻角度分别为0.2±1.4°、0.1±1.3°、0.1±1.6°和0.3±1.7°,胫股关节对线分别为5.2±1.9°、4.7±1.9°、4.9±1.9°和5.1±2.0°外翻,表明各组之间无差异(p>0.05)。关于胫骨植入物对线的准确性,第1、2、3和4组分别有98.1%、97.6%、87.5%和86.7%的病例内翻角度为0±3°,表明第3组和第4组的准确性水平降低(p<0.0001)。胫股关节对线方面无差异,每组分别有83.9%、82.9%、85.4%和86.7%的病例显示外翻角度为6±3°(p>0.05)。
在微创全膝关节置换术中,无论内翻畸形程度如何,均可实现满意的假体对线。