Leelasestaporn C, Thuwapitchayanant M, Sirithanapipat P, Sa-Ngasoongsong P, Ruengsilsuwit P
Department of Orthopaedic Surgery, Bhumibol Adulyadej Hospital, Bangkok, Thailand.
Department of Total Joint Replacement Center, Vejthani Hospital, Bangkok, Thailand.
Malays Orthop J. 2021 Mar;15(1):79-84. doi: 10.5704/MOJ.2103.012.
The aim of this study was to evaluate the reliability of the femoral component rotation on intra-operative data recorded in a computer-assisted navigation system (CAN-FRA) compared with the post-operative femoral component rotation observed on computed tomography (CT-FRA).
Computer-assisted total knee arthroplasty (TKA) or primary osteoarthritis of the knee was performed in 51 knees in 36 patients with a mean age of 69.51 years. All procedures were performed by a single surgeon using the same implant design. The intraclass correlation coefficient (ICC) was used to compare the intra-operative CAN-FRA with the post-operative CT-FRA. The angle between the anatomical epicondylar axis and the posterior condylar axis of the implant (CT-FRA) was measured at two separate timepoints by three observers who were blinded to the intra-operative CAN-FRA. Internal rotation was defined as rotation in the negative direction, while external rotation was defined as positive.
The mean intra-operative CAN-FRA was 0.1° ± 2.8° (range -5.0° to 5.5°). The mean post-operative CT-FRA was -1.3° ± 2.1° (range -4.6° to 4.4°). The mean difference between the CAN-FRA and the CT-FRA was -1.3° ± 2.2° (range -7.9° to 2.4°). The respective ICC values for the three observers were 0.92, 0.94, and 0.93, while the respective intra-observer coefficients were 0.91, 0.85, and 0.90. The ICC for the intra-operative CAN-FRA versus the post-operative CT-FRA was 0.71.
This study shows that using a computer-assisted navigation system in TKA achieves reliable results and helps to achieve optimal positioning of the femoral component and rotation alignment correction.
本研究的目的是评估计算机辅助导航系统记录的术中股骨组件旋转数据（CAN-FRA）与术后计算机断层扫描观察到的股骨组件旋转（CT-FRA）的可靠性。
对36例平均年龄69.51岁患者的51个膝关节进行了计算机辅助全膝关节置换术（TKA）或原发性膝关节骨关节炎手术。所有手术均由同一位外科医生使用相同的植入物设计进行。组内相关系数（ICC）用于比较术中CAN-FRA与术后CT-FRA。由三名对术中CAN-FRA不知情的观察者在两个不同时间点测量植入物的解剖上髁轴与后髁轴之间的角度（CT-FRA）。内旋定义为负向旋转，外旋定义为正向旋转。
术中CAN-FRA的平均值为0.1°±2.8°（范围为-5.0°至5.5°）。术后CT-FRA的平均值为-1.3°±2.1°（范围为-4.6°至4.4°）。CAN-FRA与CT-FRA之间的平均差值为-1.3°±2.2°（范围为-7.9°至2.4°）。三名观察者各自的ICC值分别为0.92、0.94和0.93，而观察者内系数分别为0.91、0.85和0.90。术中CAN-FRA与术后CT-FRA的ICC为0.71。
本研究表明在TKA中使用计算机辅助导航系统可获得可靠结果，并有助于实现股骨组件的最佳定位和旋转对线校正。
