Chompoosang Thakrit, Khongphaophong Methee, Chunsiri Pat, Sripirom Pornpavit
J Med Assoc Thai. 2016 Feb;99 Suppl 2:S168-74.
A number of previous studies have shown that conventional total knee arthroplasty (TKA) can affect talar tilt (TT) in the ankle of the operated leg. We aimed to prevent this problem by utilizing computer-assisted Total Knee Arthroplasty (CAS-TKA).
To compare pre- and post-operative talar tilt and ankle clinical assessment after computer-assisted total knee arthroplasty (CAS-TKA) and conventional total knee arthroplasty (TKA) in the 56 knees of 28 patients who underwent bilateral TKA.
We studied the 56 knees of 28 patients who underwent computer-assisted total knee arthroplasty (CAS-TKA) in one knee and conventional total knee arthroplasty (TKA) in the other A combination of the Gap Balancing and Measured Resection techniques was used, and the operations were performed by a single surgeon. At follow-up 12 months post-operatively, we examined ankle radiographic findings for tibio-talar angle (TTA), tibial articular surface angle (TAS), and talar tilt (TT) which was taken as the difference between TAS and TTA. Ankle clinical assessment was performed using the foot functional index (FF) in both groups pre- and post-operatively. The study also compared the results of computer-assisted total knee arthroplasty with those of conventional total knee arthroplasty pre- and post-operatively.
We studied the 56 knees of 28 patients whose mean age was 67.79 years and who underwent bilateral total knee arthroplasty. Comparison of pre-operative and postoperative TT in the Conventional group showed a significant difference (p = 0.016), while there was no significant difference in the CAS group (p = 0.657). Ankle clinical assessment using foot functional index (FFI) revealed that there was no significant difference in the pre-operative FFI in the Conventional group = 1.85 (0.81, 6.88) and that of the CAS group = 1.91 (0.24, 66.5) (p = 0.577). The post-operative FFI in the Conventional group was 1.68 (0.24, 7.0) and in the CAS group it was 1.65 (0.24, 6.76), and these results were statistically significant (p = 0.047). In the Conventional group, the postoperative FFI was not significantly different from pre-operative FFI (p = 0.269), but in the CAS group there was a significant difference (p = 0.047).
This study showed that conventional total knee arthroplasty affected postoperative talar tilt while computer-assisted total knee arthroplasty had a lesser effect and did not significantly change the axis of rotation of the ankle joint. More research needs to be carried out on larger numbers of patients with longer follow-up periods.
此前多项研究表明，传统全膝关节置换术（TKA）会影响手术侧踝关节的距骨倾斜度（TT）。我们旨在通过使用计算机辅助全膝关节置换术（CAS-TKA）来预防这一问题。
比较28例行双侧TKA患者的56个膝关节在接受计算机辅助全膝关节置换术（CAS-TKA）和传统全膝关节置换术（TKA）前后的距骨倾斜度及踝关节临床评估情况。
我们研究了28例患者的56个膝关节，其中一个膝关节接受计算机辅助全膝关节置换术（CAS-TKA），另一个膝关节接受传统全膝关节置换术（TKA）。采用间隙平衡和测量截骨技术相结合的方法，手术由同一位外科医生进行。术后12个月随访时，我们检查踝关节X线片结果，测量胫距角（TTA）、胫骨关节面角（TAS）以及距骨倾斜度（TT，取TAS与TTA之差）。两组患者术前和术后均使用足部功能指数（FF）进行踝关节临床评估。该研究还比较了计算机辅助全膝关节置换术与传统全膝关节置换术术前和术后的结果。
我们研究了28例平均年龄为67.79岁且接受双侧全膝关节置换术患者的56个膝关节。传统组术前和术后TT比较有显著差异（p = 0.016），而计算机辅助组无显著差异（p = 0.657）。使用足部功能指数（FFI）进行的踝关节临床评估显示，传统组术前FFI为1.85（0.81，6.88），计算机辅助组为1.91（0.24，66.5），两者无显著差异（p = 0.577）。传统组术后FFI为1.68（0.24，7.0），计算机辅助组为1.65（0.24，6.76），这些结果具有统计学意义（p = 0.047）。在传统组中，术后FFI与术前FFI无显著差异（p = 0.269），但在计算机辅助组中有显著差异（p = 0.047）。
本研究表明，传统全膝关节置换术会影响术后距骨倾斜度，而计算机辅助全膝关节置换术影响较小，且不会显著改变踝关节的旋转轴。需要对更多患者进行更长时间的随访研究。
