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全膝关节置换患者中定制器械与传统技术的比较:一项观察性前瞻性研究。

Comparison between patient specific instrumentation and traditional technique in patients with total knee arthroplasty: An observational perspective study.

作者信息

Rigoni Sergio, Libera Martina Dalla, Pigatto Diego, Conte Davide, Ceccato Alessandro, Chemello Cesare

机构信息

Hospital of Asiago, Health Units 7 "Pedemontana", Italy.

Hospital of Bassano, Health Units 7 "Pedemontana", Italy.

出版信息

J Orthop. 2021 Feb 11;23:264-272. doi: 10.1016/j.jor.2021.01.013. eCollection 2021 Jan-Feb.

Abstract

BACKGROUND

Total knee arthroplasty surgery (TKA) using prenavigated Patient Specific Instruments (PSI) technique represents one of the most recent technological evolutions in development of prosthetic surgery. The aim of this study was to evaluate kinematic and functional recovery of patients operated with prenavigated PSI technique compared to those operated with traditional technique.

METHODS

A cohort of 20 patients is divided in two groups; some are operated with traditional technique (with NexGen Knee system) and others with prenavigated PSI technique (with eMP Knee system) at Asiago Hospital. Limb circumferences are measured for edema evaluation and different evaluation forms are provided to patients: SF-36, KSS pre-surgery (T0), KSS 15 (T1) and 45 days after surgery (T2). is performed 60 days post-surgery, after leaving crutches.

RESULTS

The analysis of KSS and SF-36 evaluation forms shows a greater improvement in PSI Evolution group in terms of articulation (comparison between T0 and T1), knee function and early return to physical and social activities. Pain is lesser in NexGen group, in an earlier phase, but 45 days after surgery (T2) there are no significant differences between two groups. Perception of general state of health improves more and earlier in NexGen. In NexGen group edema evaluation had significant differences at the level of prosthetic leg, but not in knee and thigh. Overall: the walking pattern is more physiological in PSI Evolution group.

CONCLUSIONS

The present study highlighted the superiority of prenavigated PSI technique over traditional technique in recovering functionality of prosthetic knee and in restoring a more physiological path pattern.

摘要

背景

使用术前导航的患者特异性器械(PSI)技术进行全膝关节置换手术(TKA)是假体手术发展中最新的技术进步之一。本研究的目的是评估采用术前导航PSI技术手术的患者与采用传统技术手术的患者的运动学和功能恢复情况。

方法

一组20名患者被分为两组;一些患者在阿西亚戈医院采用传统技术(使用NexGen膝关节系统)进行手术,另一些患者采用术前导航PSI技术(使用eMP膝关节系统)进行手术。测量肢体周长以评估水肿情况,并向患者提供不同的评估表格:SF-36、术前(T0)的膝关节协会评分(KSS)、术后15天(T1)和术后45天(T2)的KSS。术后60天,在患者不再使用拐杖后进行[具体检查未提及]。

结果

对KSS和SF-36评估表格的分析表明,在关节活动度(T0和T1之间的比较)、膝关节功能以及早期恢复身体和社交活动方面,PSI Evolution组有更大的改善。NexGen组在早期疼痛较轻,但术后45天(T2)两组之间没有显著差异。NexGen组对总体健康状况的感知改善得更早且更明显。在NexGen组中,假体腿水平的水肿评估有显著差异,但膝关节和大腿部位没有。总体而言:PSI Evolution组的行走模式更符合生理。

结论

本研究强调了术前导航PSI技术在恢复人工膝关节功能和恢复更符合生理的步态模式方面优于传统技术。

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