Zhang Yuan Z, Lu Sheng, Zhang Hui Q, Jin Zhong M, Zhao Jian M, Huang Jian, Zhang Zhi F
Department of Orthopaedics, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, People's Republic of China.
Department of Orthopaedics, Kunming General Hospital, PLA, Kunming, People's Republic of China.
Int J Comput Assist Radiol Surg. 2016 Oct;11(10):1881-90. doi: 10.1007/s11548-016-1382-7. Epub 2016 Mar 26.
The success of total knee arthroplasty (TKA) depends on many factors. The position of a prosthesis is vitally important. The purpose of the present study was to evaluate the value of a computer-aided establishing lower extremity mechanical axis in TKA using digital technology.
A total of 36 cases of patients with TKA were randomly divided into the computer-aided design of navigation template group (NT) and conventional intramedullary positioning group (CIP). Three-dimensional (3D) CT scanning images of the hip, knee, and ankle were obtained in NT group. X-ray images and CT scans were transferred into the 3D reconstruction software. A 3D bone model of the hip, knee, ankle, as well as the modified loading, was reconstructed and saved in a stereolithographic format. In the 3D reconstruction model, the mechanical axis of the lower limb was determined, and the navigational templates produced an accurate model using a rapid prototyping technique. The THA in CIP group was performed according to a routine operation. CT scans were performed postoperatively to evaluate the accuracy of the two TKA methods.
The averaged operative time of the NT group procedures was [Formula: see text] min shorter than those of the conventional procedures ([Formula: see text] min). The coronal femoral angle, coronal tibial angle, posterior tibial slope were [Formula: see text], [Formula: see text], [Formula: see text] in NT group and [Formula: see text], [Formula: see text], [Formula: see text] in CIP group, respectively. Statistically significant group differences were found.
The navigation template produced through mechanical axis of lower extremity may provide a relative accurate and simple method for TKA.
全膝关节置换术(TKA)的成功取决于多种因素。假体的位置至关重要。本研究的目的是评估利用数字技术在TKA中计算机辅助建立下肢机械轴的价值。
36例TKA患者被随机分为导航模板计算机辅助设计组(NT)和传统髓内定位组(CIP)。NT组获取了髋、膝、踝关节的三维(3D)CT扫描图像。X线图像和CT扫描被传输到3D重建软件中。重建了髋、膝、踝关节的3D骨模型以及改良负重模型,并以立体光刻格式保存。在3D重建模型中确定下肢的机械轴,并使用快速成型技术制作导航模板以生成精确模型。CIP组的TKA按照常规手术进行。术后进行CT扫描以评估两种TKA方法的准确性。
NT组手术的平均操作时间比传统手术短[公式:见原文]分钟([公式:见原文]分钟)。NT组的股骨冠状角、胫骨冠状角、胫骨后倾分别为[公式:见原文]、[公式:见原文]、[公式:见原文],CIP组分别为[公式:见原文]、[公式:见原文]、[公式:见原文]。发现两组间存在统计学显著差异。
通过下肢机械轴制作的导航模板可能为TKA提供一种相对准确且简单的方法。