Koenen P, Schneider M M, Pfeiffer T R, Bouillon B, Bäthis H
Department of Orthopaedics, Trauma Surgery and Sports Medicine, Cologne-Merheim Medical Center, University of Witten/Herdecke, Cologne, Germany.
Adv Orthop. 2018 Feb 8;2018:5042536. doi: 10.1155/2018/5042536. eCollection 2018.
BACKGROUND: Restoration of the mechanical axis is a main objective in total knee replacement (TKR). Aim of this study was to analyse the verification tool of a pinless navigation system in conventional TKR (cTKR). METHODS: In a prospective study, 147 TKR were performed by conventional technique. Using the "pinless verification" mode of a smartphone based navigation system, the cutting block position and final resection plane for distal femur and proximal tibial resection were measured. If necessary, the block position or resection level were optimized, corrections were protocolled. Postoperatively, standardized radiographs were performed. RESULTS: In 65.3%, intraoperative measurements changed the surgical procedure (corrections: 20.4% femoral, 25.9% tibial, 19% both). The additional time for surgery compared to cTKR averaged 6 minutes (79 ± 15 versus 73 ± 17 minutes). Using navigation data, the final femoral and tibial axes were in 93% within a range of ±2°. A mean difference of 1.4° and 1.6° could be shown between the final measurement of the navigation system and the postoperative mLDFA and mMPTA. CONCLUSION: Intraoperative pinless navigation has impact on the surgical procedure in the majority of cTKR. It represents a less time-consuming tool to improve implant position while maintaining the routine of conventional technique.
背景:恢复机械轴是全膝关节置换术(TKR)的主要目标。本研究的目的是分析传统全膝关节置换术(cTKR)中无针导航系统的验证工具。 方法:在一项前瞻性研究中,采用传统技术进行了147例全膝关节置换术。使用基于智能手机的导航系统的“无针验证”模式,测量股骨远端和胫骨近端截骨的截骨模块位置和最终截骨平面。如有必要,优化模块位置或截骨水平,并记录校正情况。术后进行标准化X线摄影。 结果:在65.3%的病例中,术中测量改变了手术过程(校正情况:股骨20.4%,胫骨25.9%,两者均为19%)。与传统全膝关节置换术相比,手术额外时间平均为6分钟(79±15分钟对73±17分钟)。利用导航数据,最终股骨和胫骨轴在±2°范围内的比例为93%。导航系统的最终测量值与术后机械外侧远端股骨角(mLDFA)和机械近端胫骨角(mMPTA)之间的平均差异分别为1.4°和1.6°。 结论:术中无针导航对大多数传统全膝关节置换术的手术过程有影响。它是一种耗时较少的工具,可在保持传统技术常规操作的同时改善植入物位置。
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