Department of Orthopaedics, The Third Hospital of Changsha, Changsha, China.
Department of Radiology, The Third Hospital of Changsha, Changsha, China.
J Orthop Surg Res. 2021 May 12;16(1):309. doi: 10.1186/s13018-021-02467-6.
The purpose of this study was to determine whether the gap-balancing technique with patient-specific instrumentation (PSI) and a new balancing device in total knee arthroplasty (TKA) can improve knee function to a greater extent than can the measured resection technique.
Data from 150 patients who underwent TKA from August 2014 to June 2016 were studied retrospectively. The gap-balancing technique assisted by PSI and the new balancing device was used in 80 patients (82 knees), and the measured resection technique was used in 70 patients (70 knees). The surgical, imaging, and knee function data were compared.
The gap-balancing technique assisted by PSI and the new balancing device was found to be feasible in all operated knees and reliable. In total, 150 patients (152 knees) of ages ranging from 52 to 78 years (mean 67 years) underwent TKA during the study period. The follow-up period ranged from 35 to 52 months (mean 45 months). Only one patient, who was included in the gap-balancing group, underwent a revision surgery at 2 years postoperatively due to infection. There were no differences in the incidence of anterior knee pain between the two groups. The mean flexion angle, KSS scores, and VAS scores did not significantly differ between the measured resection group and gap-balancing group at 12 weeks or 36 weeks postoperatively. The average joint line displacement was 1.3 ± 1.1 mm (range 0-3) proximally in the GB (gap-balancing) group and 1.2 ± 1.4 mm in the MR (measured-resection) group. No outliers >5 mm in either group were recorded. The mean leg axis deviation from the neutral mechanical axis was 1.8°±1.5° varus (range 0°-3°varus) versus the neutral mechanical axis in the GB group and 1.4°±1.2°(range 0°-3°)in the MR group. No outliers with >3° deviation in either group were recorded.
The gap-balancing technique performed with the new balancing device and PSI can yield accurate femoral component alignment as well as outcomes similar to those of measured resection at 3 years. The new balancing device can be taken into consideration by surgeons who prefer performing the gap-balancing technique with PSI.
本研究旨在确定在全膝关节置换术（TKA）中使用患者特异性截骨工具（PSI）和新型平衡装置进行间隙平衡技术是否比使用测量截骨技术能更大程度地改善膝关节功能。
回顾性分析 2014 年 8 月至 2016 年 6 月期间接受 TKA 的 150 例患者的数据。80 例（82 膝）患者采用 PSI 辅助间隙平衡技术和新型平衡装置，70 例（70 膝）患者采用测量截骨技术。比较手术、影像学和膝关节功能数据。
PSI 和新型平衡装置辅助间隙平衡技术在所有手术膝关节中均可行且可靠。在研究期间，共有 150 例（152 膝）年龄 52-78 岁（平均 67 岁）的患者接受了 TKA。随访时间为 35-52 个月（平均 45 个月）。只有 1 例患者（间隙平衡组）因感染在术后 2 年接受了翻修手术。两组患者的前膝疼痛发生率无差异。术后 12 周和 36 周时，测量截骨组和间隙平衡组的平均膝关节屈曲角度、KSS 评分和 VAS 评分无显著差异。GB（间隙平衡）组关节线平均近端移位 1.3±1.1mm（范围 0-3），MR（测量截骨）组为 1.2±1.4mm。两组均无>5mm 的离群值。GB 组从机械中立轴平均下肢轴线偏差为 1.8°±1.5°（范围 0°-3°），MR 组为 1.4°±1.2°（范围 0°-3°）。两组均无>3°的离群值。
使用新型平衡装置和 PSI 进行间隙平衡技术可以获得准确的股骨组件对线，并且在 3 年时的结果与测量截骨相似。该新型平衡装置可被偏好使用 PSI 进行间隙平衡技术的外科医生所考虑。
