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使用基于iPod的导航系统在全膝关节置换术中实现可靠对线

Reliable Alignment in Total Knee Arthroplasty by the Use of an iPod-Based Navigation System.

作者信息

Koenen Paola, Schneider Marco M, Fröhlich Matthias, Driessen Arne, Bouillon Bertil, Bäthis Holger

机构信息

Department of Orthopaedics, Trauma Surgery and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, 51109 Cologne, Germany.

Department of Orthopaedics, Trauma Surgery and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, 51109 Cologne, Germany; Department of Orthopaedic Surgery, Schulthess Clinic, 8008 Zurich, Switzerland.

出版信息

Adv Orthop. 2016;2016:2606453. doi: 10.1155/2016/2606453. Epub 2016 May 30.

DOI:10.1155/2016/2606453
PMID:27313898
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4904084/
Abstract

Axial alignment is one of the main objectives in total knee arthroplasty (TKA). Computer-assisted surgery (CAS) is more accurate regarding limb alignment reconstruction compared to the conventional technique. The aim of this study was to analyse the precision of the innovative navigation system DASH® by Brainlab and to evaluate the reliability of intraoperatively acquired data. A retrospective analysis of 40 patients was performed, who underwent CAS TKA using the iPod-based navigation system DASH. Pre- and postoperative axial alignment were measured on standardized radiographs by two independent observers. These data were compared with the navigation data. Furthermore, interobserver reliability was measured. The duration of surgery was monitored. The mean difference between the preoperative mechanical axis by X-ray and the first intraoperatively measured limb axis by the navigation system was 2.4°. The postoperative X-rays showed a mean difference of 1.3° compared to the final navigation measurement. According to radiographic measurements, 88% of arthroplasties had a postoperative limb axis within ±3°. The mean additional time needed for navigation was 5 minutes. We could prove very good precision for the DASH system, which is comparable to established navigation devices with only negligible expenditure of time compared to conventional TKA.

摘要

轴向对线是全膝关节置换术（TKA）的主要目标之一。与传统技术相比，计算机辅助手术（CAS）在肢体对线重建方面更为精确。本研究的目的是分析Brainlab公司创新的导航系统DASH®的精度，并评估术中获取数据的可靠性。对40例行CAS TKA且使用基于iPod的导航系统DASH的患者进行了回顾性分析。由两名独立观察者在标准化X线片上测量术前和术后的轴向对线情况。将这些数据与导航数据进行比较。此外，还测量了观察者间的可靠性。监测手术时长。术前X线测量的机械轴与术中导航系统首次测量的肢体轴之间的平均差值为2.4°。术后X线显示与最终导航测量结果相比平均差值为1.3°。根据影像学测量，88%的关节置换术后肢体轴在±3°范围内。导航所需的平均额外时间为5分钟。我们可以证明DASH系统具有非常好的精度，与已有的导航设备相当，与传统TKA相比，所需时间微不足道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/f95b3ca2251d/AORTH2016-2606453.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/257d6bee9127/AORTH2016-2606453.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/38a6feaaebc7/AORTH2016-2606453.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/23ab1b1859eb/AORTH2016-2606453.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/d18cf57ef8f1/AORTH2016-2606453.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/f2586d5ddc7a/AORTH2016-2606453.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/f95b3ca2251d/AORTH2016-2606453.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/257d6bee9127/AORTH2016-2606453.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/38a6feaaebc7/AORTH2016-2606453.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/23ab1b1859eb/AORTH2016-2606453.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/d18cf57ef8f1/AORTH2016-2606453.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/f2586d5ddc7a/AORTH2016-2606453.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42c/4904084/f95b3ca2251d/AORTH2016-2606453.006.jpg

相似文献

[1]
Reliable Alignment in Total Knee Arthroplasty by the Use of an iPod-Based Navigation System.

Adv Orthop. 2016

[2]
Differences in measurement of lower limb alignment among different registration methods of navigation and radiographs in TKA using the OrthoPilot system.

Orthopedics. 2012-10

[3]
Improved accuracy of component alignment with the implementation of image-free navigation in total knee arthroplasty.

Knee Surg Sports Traumatol Arthrosc. 2008-3

[4]
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Knee Surg Sports Traumatol Arthrosc. 2017-11

[5]
Accuracy of Computed Tomography-Based Navigation-Assisted Total Knee Arthroplasty: Outlier Analysis.

J Arthroplasty. 2017-1

[6]
Intraoperative validation of bone cut accuracy of a pinless smart touch-screen navigation system device in total knee arthroplasty.

Int J Med Robot. 2019-8-22

[7]
[Rotational alignment of femoral component with computed-assisted surgery (CAS) during total knee arthroplasty].

Rev Chir Orthop Reparatrice Appar Mot. 2008-10

[8]
Comparative study between computer assisted-navigation and conventional technique in minimally invasive surgery total knee arthroplasty, prospective control study.

J Med Assoc Thai. 2008-9

[9]
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Kaohsiung J Med Sci. 2014-8

[10]
[Effect of the surgical time and coronalmechanical alignment after total knee arthroplasty using computer navigation system, traditionalor 3D printing patient-specific instruments].

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引用本文的文献

[1]
Femoral flexion position is a highly variable factor in total knee arthroplasty: an analysis of 593 conventionally aligned total knee replacements.

Knee Surg Sports Traumatol Arthrosc. 2019-5-27

[2]
Current concepts and future perspectives in computer-assisted navigated total knee replacement.

Int Orthop. 2018-5-12

[3]
Total knee arthroplasties from the origin to navigation: history, rationale, indications.

Int Orthop. 2018-3-27

本文引用的文献

[1]
Computer navigation for total knee arthroplasty reduces revision rate for patients less than sixty-five years of age.

J Bone Joint Surg Am. 2015-4-15

[2]
No difference between computer-assisted and conventional total knee arthroplasty: five-year results of a prospective randomised study.

Knee Surg Sports Traumatol Arthrosc. 2013-7-14

[3]
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Knee Surg Sports Traumatol Arthrosc. 2013-7-6

[4]
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Langenbecks Arch Surg. 2013-2-22

[5]
More accurate component alignment in navigated total knee arthroplasty has no clinical benefit at 5-year follow-up.

Acta Orthop. 2012-11-11

[6]
Computer-assisted total knee arthroplasty is currently of no proven clinical benefit: a systematic review.

Clin Orthop Relat Res. 2013-1

[7]
A prospective study comparing the functional outcome of computer-assisted and conventional total knee replacement.

J Bone Joint Surg Br. 2012-2

[8]
Neutral mechanical alignment: a requirement for successful TKA: opposes.

Orthopedics. 2011-9-9

[9]
Displays mounted on cutting blocks reduce the learning curve in navigated total knee arthroplasty.

Comput Aided Surg. 2011

[10]
Does computer-assisted surgery improve postoperative leg alignment and implant positioning following total knee arthroplasty? A meta-analysis of randomized controlled trials?

Knee Surg Sports Traumatol Arthrosc. 2011-7-6

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