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计算机断层扫描评估两种不同植入手术方法后全膝关节置换植入物的位置。

Computed tomography evaluation of total knee arthroplasty implants position after two different surgical methods of implantation.

机构信息

Department of Clinical-Surgical Sciences, Diagnostics and Pediatrics, University of Pavia, Operative Unit of Orthopaedics and Traumatology, Fondazione IRCCS Policlinico San Matteo, Via Golgi, 19, 27100, Pavia, Italy.

Interventional and Diagnostic Radiology and Neuroradiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

出版信息

Int Orthop. 2019 Jan;43(1):139-149. doi: 10.1007/s00264-018-4180-8. Epub 2018 Oct 2.

Abstract

PURPOSE

The objectives of this study were to determine the reliability of a novel method of measuring the rotational alignment of an anatomical tibial tray, the difference in the rotational alignment of the femoral and tibial component according to pure measured resection or blended technique with tensor, and, finally, the difference in terms of clinical results according to the two different methods.

PATIENTS AND METHODS

We performed a total of 60 consecutive TKAs: 30 according to pure measured resection and 30 according to blended technique with tensor (FuZion®). Clinical scores and CT scan were done at six months to measure patient's outcome and prosthetic components rotation.

RESULTS

The method of measurement of tibial tray had high agreement between different radiological observers. Mean external rotation alignment of the femur was 2.7° in standard group and 0.5° in the FuZion® group. For all clinical indices, we observed a large and significant improvement at follow-up, better in blended technique group, but without a clear superiority, and no statistically significant difference was evident between the two groups. At follow-up, HSS was to 89.7 in the FuZion® group and 89.0 in the standard group, KSS (clinical) was 92.6 in and 91.3 respectively, and KSS (Functional) was 91.0 in the FuZion® group and 87.6 in the standard group.

CONCLUSIONS

Our CT measurement method is reliable and reproducible. All patients operated with this personalized knee system design obtained excellent results; the customization of femoral rotation with a blended technique is, probably, the key to optimize the outcomes and achieve the state of forgotten knee.

摘要

目的

本研究的目的是确定一种测量解剖胫骨托旋转对线的新方法的可靠性,根据纯测量切除或混合技术与张量的股骨和胫骨部件的旋转对线的差异,最后,根据两种不同方法在临床结果方面的差异。

患者和方法

我们共进行了 60 例全膝关节置换术(TKA):30 例采用纯测量切除法,30 例采用 FuZion®混合技术。术后 6 个月进行临床评分和 CT 扫描,以测量患者的结果和假体部件的旋转。

结果

胫骨托的测量方法在不同放射学观察者之间具有高度一致性。标准组股骨外旋平均对线为 2.7°,FuZion®组为 0.5°。对于所有临床指标,我们在随访时观察到明显的大幅度改善,混合技术组更好,但没有明显优势,两组之间没有明显的统计学差异。随访时,FuZion®组 HSS 为 89.7,标准组为 89.0,KSS(临床)分别为 92.6 和 91.3,FuZion®组 KSS(功能)为 91.0,标准组为 87.6。

结论

我们的 CT 测量方法是可靠和可重复的。使用这种个性化膝关节系统设计的所有患者都获得了优异的结果;股骨旋转的定制化与混合技术相结合,可能是优化结果并实现“遗忘膝关节”状态的关键。

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