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使用间隙平衡技术的计算机导航全膝关节置换术后,肥胖对中期临床、功能和放射学结果无影响。

No influence of obesity on mid-term clinical, functional, and radiological results after computer-navigated total knee arthroplasty using a gap balancing technique.

作者信息

Kanna Raj, Brasanna Ananth, Shetty Gautam M, Ravichandran Chandramohan

机构信息

Department of Orthopaedic Surgery, Prashanth Super Speciality Hospital, Chennai, India.

Knee & Orthopaedic Clinic, Head of Clinical Research, AIMD Research, Mumbai, India.

出版信息

J Clin Orthop Trauma. 2021 Jan 8;16:136-142. doi: 10.1016/j.jcot.2021.01.001. eCollection 2021 May.


DOI:10.1016/j.jcot.2021.01.001
PMID:33717948
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7920157/
Abstract

OBJECTIVE: In obese patients, thick subcutaneous tissue can introduce errors during registration and leg weight can influence gap balancing in navigated TKA. Present study is done to determine if computer navigated TKA using a gap balancing technique can achieve consistent accuracy for limb and component alignment, and similar clinical and functional results in obese patients like in non-obese patients. METHODS: We prospectively compared the radiological, clinical, and functional results of 78 knees in 57 non-obese patients and 79 knees in 58 obese patients who underwent computer-assisted TKA. Non-obese individuals were defined as those having BMI of <30 kg/m and obese individuals as BMI ≥30 kg/m. The degree of knee deformity was calculated by Hip - Knee - Ankle (HKA) angle and clinical and functional assessment was done using the Knee Society Score - clinical knee score and Knee Society Score - function score, respectively. All these were documented before and at 6 months, 2 year, and 5 years after TKA. RESULTS: The outlier rate of postoperative limb alignment (HKA angle) was 8.9% in the obese group which was not significantly different (p =1.00) from that of the non-obese group (7.7%). Mean clinical knee scores were not significantly different between the non-obese and obese groups preoperatively (58.8 vs 57.4, p = 0.14) and at 6 months (92.7 vs 91, p = 0.06), 2 years (91.4 vs 90, p = 0.07), and 5 years (92.4 vs 91.3, p = 0.1) post-surgery. Similarly, mean functional scores were not significantly different between the non-obese and obese groups preoperatively (50.9 vs 49.9, p = 0.31) and at 6 months (92.7 vs 90.9, p = 0.06), 2 years (91.3 vs 92, p = 0.44), and 5 years (90.6 vs 91.1, p = 0.51) post-surgery. CONCLUSION: Obesity has no influence on mid-term clinical, functional, and radiological results after computer navigated TKA, done by gap balancing technique. LEVEL OF EVIDENCE: Therapeutic level II.

摘要

目的:在肥胖患者中,较厚的皮下组织可能会在配准过程中引入误差,腿部重量会影响导航全膝关节置换术(TKA)中的间隙平衡。本研究旨在确定采用间隙平衡技术的计算机导航TKA在肥胖患者中能否像在非肥胖患者中一样,实现肢体和假体对线的一致准确性以及相似的临床和功能结果。 方法:我们前瞻性地比较了57例非肥胖患者的78个膝关节和58例肥胖患者的79个膝关节在接受计算机辅助TKA后的影像学、临床和功能结果。非肥胖个体定义为体重指数(BMI)<30kg/m²的个体,肥胖个体定义为BMI≥30kg/m²的个体。膝关节畸形程度通过髋-膝-踝(HKA)角计算,临床和功能评估分别使用膝关节协会评分-临床膝关节评分和膝关节协会评分-功能评分。所有这些指标在TKA术前以及术后6个月、2年和5年时进行记录。 结果:肥胖组术后肢体对线(HKA角)的异常率为8.9%,与非肥胖组(7.7%)无显著差异(p = 1.00)。非肥胖组和肥胖组术前(58.8对57.4,p = 0.14)、术后6个月(92.7对91,p = 0.06)、2年(91.4对90,p = 0.07)和5年(92.4对91.3,p = 0.1)的平均临床膝关节评分无显著差异。同样,非肥胖组和肥胖组术前(50.9对49.9,p = 0.31)、术后6个月(92.7对90.9,p = 0.06)、2年(91.3对92,p = 0.44)和5年(90.6对91.1,p = 0.51)的平均功能评分也无显著差异。 结论:肥胖对采用间隙平衡技术的计算机导航TKA术后的中期临床、功能和影像学结果没有影响。 证据水平:治疗性II级。

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[1]
No influence of obesity on mid-term clinical, functional, and radiological results after computer-navigated total knee arthroplasty using a gap balancing technique.

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本文引用的文献

[1]
Clinical and radiographic outcomes of computer-navigated total knee arthroplasty are not adversely affected by body mass index.

J Orthop. 2019-11-12

[2]
Comparison of computer-assisted navigation and conventional instrumentation for bilateral total knee arthroplasty: The outcomes at mid-term follow-up.

Medicine (Baltimore). 2019-11

[3]
Effect of Obesity on Component Alignment in Total Knee Arthroplasty.

Ochsner J. 2018

[4]
Does Obesity Affect Clinical and Radiological Outcomes in Minimally Invasive Total Knee Arthroplasty? Minimum 5-Year Follow-up of Minimally Invasive TKA in Obese Patients.

Clin Orthop Surg. 2018-9

[5]
Computer-Assisted Compared with Conventional Total Knee Replacement: A Multicenter Parallel-Group Randomized Controlled Trial.

J Bone Joint Surg Am. 2018-8-1

[6]
The influence of obesity on functional outcome and quality of life after total knee arthroplasty: a ten-year follow-up study.

Bone Joint J. 2018-5-1

[7]
Navigated versus conventional total knee arthroplasty: A prospective study at three years follow-up.

Rev Esp Cir Ortop Traumatol (Engl Ed). 2018

[8]
Can obesity and physical activity predict outcomes of elective knee or hip surgery due to osteoarthritis? A meta-analysis of cohort studies.

BMJ Open. 2018-2-27

[9]
Twelve-Year Follow-Up of Navigated Computer-Assisted Versus Conventional Total Knee Arthroplasty: A Prospective Randomized Comparative Trial.

J Arthroplasty. 2017-12-21

[10]
Current state of computer navigation and robotics in unicompartmental and total knee arthroplasty: a systematic review with meta-analysis.

Knee Surg Sports Traumatol Arthrosc. 2016-11

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