Feczko Peter Z, Fokkenrood Hugo J P, van Assen Tijmen, Deckers Patrick, Emans Pieter J, Arts Jacobus J
Dept. of Orthopedic Surgery, CAPHRI Research School, Maastricht University Medical Centre, Maastricht, The Netherlands.
Dept. of General Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
Knee. 2017 Oct;24(5):1213-1220. doi: 10.1016/j.knee.2017.07.018. Epub 2017 Aug 16.
The aim of this study was to compare the accuracy of the oscillating tip saw system (Precision Saw=PS) with the more conventional fully oscillating blade system (Sagittal Saw=SS) during computer-assisted total knee arthroplasty (CAS-TKA).
A prospective, randomised, controlled trial included 58 consecutive patients who underwent primary CAS-TKA and were randomly assigned in the PS group or the SS group to compare the accuracy of both blades. The primary outcome was the difference between the intended cutting planes and the actual cutting planes in degrees (°) in two planes of both the femur and the tibia. The secondary outcome was total surgery time.
Tibia: In the VV-plane no significant differences were registered for the mean absolute deviation (p=0.28). The PS was more accurate in the AP-plane (p=0.03). Femur: The PS showed significantly fewer mean absolute deviations in the VV-plane (p=0.03); however, the SS revealed better accuracy in the FE-plane (p=0.04). The difference in the surgery time between the groups was not statistically significant (p=0.45). Two outliers were measured using the SS, while seven outliers were detected using the PS.
The Precision Saw is not proven to be overall more accurate than the Sagittal Saw. Significantly better accuracy was shown with the PS in the two cutting planes, with the exception of one cutting plane that favoured the SS. Greater number of outliers were found using the PS.
II.
本研究旨在比较在计算机辅助全膝关节置换术(CAS-TKA)中,摆动锯片系统(精密锯=PS)与更传统的全摆动锯片系统(矢状锯=SS)的准确性。
一项前瞻性、随机、对照试验纳入了58例连续接受初次CAS-TKA的患者,他们被随机分配到PS组或SS组,以比较两种锯片的准确性。主要结局是股骨和胫骨两个平面上预期切割平面与实际切割平面之间的角度(°)差异。次要结局是总手术时间。
胫骨:在VV平面,平均绝对偏差无显著差异(p=0.28)。PS在AP平面更准确(p=0.03)。股骨:PS在VV平面的平均绝对偏差显著更少(p=0.03);然而,SS在FE平面显示出更好的准确性(p=0.04)。两组之间的手术时间差异无统计学意义(p=0.45)。使用SS测量到2个异常值,而使用PS检测到7个异常值。
尚未证明精密锯总体上比矢状锯更准确。除了一个有利于SS的切割平面外,PS在两个切割平面上显示出显著更好的准确性。使用PS发现的异常值更多。
II级。