Tani Izumi, Nakano Naoki, Takayama Koji, Ishida Kazunari, Kuroda Ryosuke, Matsumoto Tomoyuki
. Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
. Department of Orthopedic Surgery, Kobe Kaisei Hospital, Kobe, Japan.
Acta Ortop Bras. 2018 May-Jun;26(3):170-174. doi: 10.1590/1413-785220182603178367.
It is difficult to achieve proper alignment after total knee arthroplasty (TKA) in patients with extra-articular deformity (EAD) because of altered anatomical axis and distorted landmarks. As of this writing, only case series have been reported with regard to the usefulness of computer-assisted navigation systems for TKA with EAD. This study therefore compared outcomes in TKA with EAD, with and without navigation.
Fourteen osteoarthritis patients with EAD due to previous fracture malunion or operations were assessed. Seven TKAs were performed with navigation (navigation group) and another 7 were performed without navigation (manual group). Clinical and radiographic outcomes were compared before and two years after surgery.
The mean postoperative Knee Society function score was significantly higher in the navigation group. No significant difference was found in postoperative range of motion and Knee Society knee score. The rate of outliers in radiographic outcomes tended to be lower in the navigation group.
Better clinical outcomes were achieved in cases in which navigation was used. Computer-assisted navigation is useful in TKA for patients with EAD.
由于关节外畸形（EAD）患者的解剖轴改变和标志点扭曲，全膝关节置换术（TKA）后难以实现正确对线。截至撰写本文时，关于计算机辅助导航系统在EAD患者TKA中的应用，仅报道了病例系列。因此，本研究比较了有导航和无导航的EAD患者TKA的结果。
评估了14例因既往骨折畸形愈合或手术导致EAD的骨关节炎患者。7例TKA手术采用导航（导航组），另外7例手术未采用导航（手动组）。比较术前和术后两年的临床和影像学结果。
导航组术后膝关节协会功能评分均值显著更高。术后活动范围和膝关节协会膝关节评分无显著差异。导航组影像学结果中的异常值发生率趋于更低。
使用导航的病例取得了更好的临床结果。计算机辅助导航在EAD患者的TKA中有用。
