Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
J Knee Surg. 2021 Jul;34(8):870-876. doi: 10.1055/s-0039-3402481. Epub 2019 Dec 31.
Several studies have reported better clinical outcomes following kinematically aligned total knee arthroplasty (KA-TKA) than mechanically aligned TKA. Consistent reproduction of a KA-TKA is aided by accurate tibial bone resections using computer navigation systems. This study compares an accelerometer-based portable navigation system with a conventional navigation system on tibial bone resection and clinical outcomes in KA-TKA. This study included 60 knees of patients who underwent primary KA-TKA between May 2015 and September 2017. They were randomly assigned to the OrthoPilot and iASSIST groups. A tibial bone cut was performed with 3 degree varus and 7 degree posterior slope in relation to the mechanical axis in all cases. The tibial component angle (TCA) and posterior slope angle (PSA) were evaluated by postoperative radiography, and those that deviated more than 2 degree were set as outliers. The clinical outcomes were the knee range of motion (ROM) and 2011 Knee Society Score (KSS) evaluated at 1 year postoperation. The groups were compared in terms of the TCA, PSA, number of outliers, ROM, and 2011 KSS ( < 0.05). No significant difference was observed between the groups in terms of the mean TCA, PSA, number of outliers, ROM, and categories of the 2011 KSS (objective knee indicators, symptoms, satisfaction, expectations, and functional activities). Although tibial bone cuts were performed with 3 degree varus and 7 degree posterior slope, no significant difference was observed between the OrthoPilot and iASSIST groups in terms of the accuracy of cuts or postoperative clinical result. The iASSIST was found to be a simple and useful navigation system for KA-TKA.
多项研究报道，与机械对线全膝关节置换术（TKA）相比，运动学对线全膝关节置换术（KA-TKA）的临床效果更好。使用计算机导航系统进行准确的胫骨截骨有助于一致复制 KA-TKA。本研究比较了基于加速度计的便携式导航系统和传统导航系统在 KA-TKA 胫骨截骨和临床结果方面的差异。本研究纳入了 2015 年 5 月至 2017 年 9 月期间接受初次 KA-TKA 的 60 例患者的膝关节。他们被随机分配到 OrthoPilot 和 iASSIST 组。所有患者的胫骨均采用机械轴 3 度内翻和 7 度后倾进行截骨。术后通过 X 线评估胫骨组件角度（TCA）和后倾角度（PSA），将偏离超过 2 度的病例设为离群值。临床结果是术后 1 年膝关节活动度（ROM）和 2011 年膝关节学会评分（KSS）。比较两组的 TCA、PSA、离群值的数量、ROM 和 2011 KSS（ < 0.05）。两组的平均 TCA、PSA、离群值的数量、ROM 和 2011 KSS（客观膝关节指标、症状、满意度、期望和功能活动）的分类均无显著差异。虽然胫骨截骨采用 3 度内翻和 7 度后倾，但 OrthoPilot 和 iASSIST 两组在截骨的准确性和术后临床结果方面无显著差异。iASSIST 是一种用于 KA-TKA 的简单而有用的导航系统。
