Hernandez-Vaquero D, Noriega-Fernandez A, Suarez-Vazquez A, Roncero-Gonzalez S, Sierra-Pereira A A, Gil-Martinez L, Fernandez-Carreira J M
Departamento de Cirugía, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, España; Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario San Agustín, Avilés, España.
Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario San Agustín, Avilés, España.
Rev Esp Cir Ortop Traumatol. 2017 Sep-Oct;61(5):313-318. doi: 10.1016/j.recot.2017.03.007. Epub 2017 Jul 4.
To establish the concordance between angulation of the femoro-tibial mechanical axis measured with x-rays and surgical navigation in both the pre and postoperative period after a total knee arthroplasty (TKA) was implanted.
Pre and postoperative measurements were analyzed in 88 TKA of the same model and all performed with the same surgical navigation system. The mechanical frontal angle (MFA) and femoro-tibial anatomic angle were measured before and after the TKA. The angulation was digitally measured with a teleradiography. In the navigation, the femoro-tibial angle at rest, forced varus and valgus were registered and the average of these three measurements was calculated.
The mean preoperative MFA measured on the radiograph was 4.55°. The mean of the same angle measured on the postoperative radiograph was 1.72°, (p=0.05). The mean of the MFA measured with navigation before TKA was 3.12° and after the implant with navigation was 0.53 (P=.013). The concordance coefficient between the MFA in teleradiography and in navigation was 0.869 (P<.001) preoperatively and 0.709 postoperatively (P=.017).
We found a strong concordance between radiographic and surgical navigation measurements of the MFA. This may imply that teleradiography is not necessary when using surgical navigation in TKA.
在全膝关节置换术（TKA）植入前后，建立X线测量与手术导航测量的股骨-胫骨机械轴角度之间的一致性。
对88例同一型号的TKA进行术前和术后测量，所有测量均使用同一手术导航系统。在TKA前后测量机械额状角（MFA）和股骨-胫骨解剖角。角度通过远程放射摄影进行数字测量。在导航中，记录静息、强迫内翻和外翻时的股骨-胫骨角度，并计算这三个测量值的平均值。
术前X线片上测得的平均MFA为4.55°。术后X线片上测得的同一角度的平均值为1.72°，（p=0.05）。TKA术前导航测量的MFA平均值为3.12°，植入后导航测量的MFA平均值为0.53（P=0.013）。术前远程放射摄影和导航中MFA的一致性系数为0.869（P<0.001），术后为0.709（P=0.017）。
我们发现MFA的影像学测量与手术导航测量之间有很强的一致性。这可能意味着在TKA中使用手术导航时，远程放射摄影不是必需的。
