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新型计算机导航系统辅助全膝关节置换术的短期疗效

[Short-term effectiveness of novel computer navigation system assisted total knee arthroplasty].

作者信息

Tang Qiheng, Zhou Yixin, Guo Shengjie, Deng Wang, Wang Zhaolun

机构信息

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, 100035, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Oct 15;35(10):1281-1285. doi: 10.7507/1002-1892.202105114.


DOI:10.7507/1002-1892.202105114
PMID:34651481
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8505941/
Abstract

OBJECTIVE: To investigate the short-term effectiveness of novel computer navigation system (Knee 3 software; Brainlab, Germany) assisted total knee arthroplasty (TKA). METHODS: Between July 2020 and December 2020, 19 patients underwent unilateral TKA assisted with Knee 3 software. There were 4 males and 15 females. The mean age was 66.3 years (range, 52-79 years). Eighteen patients were diagnosed with osteoarthritis and 1 patient with rheumatoid arthritis. Sixteen patients had varus knees and 3 patients had valgus knees. Preoperative Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain, stiffness, function, and total scores were 12.4±3.4, 2 (1, 4), 22 (18, 29), and 37 (29, 43), respectively. Intraoperatively, the medial and lateral gaps in knee extension and in 90° of knee flexion were recorded. The operation time, intraoperative blood loss, blood transfusion, and complications were recorded. The hip-knee-ankle angle (HKA), lateral distal femoral angle, and medial proximal tibial angle were measured to evaluate lower limb alignment and prostheses's alignment using X-ray films at 6 weeks after operation. Patient's satisfaction rate and WOMAC pain, stiffness, function, and total scores were investigated. RESULTS: Eighteen patients (94.7%) had medial- lateral gap balancing in knee extension, 18 patients (94.7%) had medial-lateral gap balancing in 90° of knee flexion, 19 patients (100%) had medial gap balancing between knee extension and 90° of knee flexion, and 18 patients (94.7%) had lateral gap balancing between knee extension and 90° of knee flexion. The mean operation time was 126 minutes (range, 100-200 minutes). The mean intraoperative blood loss was 205 mL (range, 100-400 mL). Patients were followed up 4-8 months, with an average of 6.2 months. Postoperative complications included 1 deep vein thrombosis of lower extremities and 1 cerebral infarction. X-ray films showed that the mean HKA, lateral distal femoral angle, and medial proximal tibial angle were 179.8° (range, 178°-182°), 83.5° (range, 80°-87°), and 89.5° (range, 87°-93°), respectively. At last follow-up, WOMAC pain, stiffness, function, and total scores were 3.6±1.9, 0 (0, 2), 4 (2, 6), and 9 (5, 10), respectively, which improved when compared with preoperative scores ( <0.05). Twelve patients were very satisfied with the operation results and 7 patients were satisfied with the operation results. The overall satisfaction rate was 100%. CONCLUSION: Knee 3 software can help to obtain good gap balancing and optimal lower limb alignment, with high patient's satisfaction and good short-term effecectiveness.

摘要

目的:探讨新型计算机导航系统(Knee 3软件;德国Brainlab公司)辅助全膝关节置换术(TKA)的短期疗效。 方法:2020年7月至2020年12月,19例患者接受了Knee 3软件辅助的单侧TKA。其中男性4例,女性15例。平均年龄66.3岁(范围52 - 79岁)。18例患者诊断为骨关节炎,1例患者诊断为类风湿关节炎。16例患者为膝内翻,3例患者为膝外翻。术前西安大略和麦克马斯特大学骨关节炎指数(WOMAC)疼痛、僵硬、功能和总分分别为12.4±3.4、2(1,4)、22(18,29)和37(29,43)。术中记录膝关节伸直位和屈膝90°时的内外侧间隙。记录手术时间、术中出血量、输血情况及并发症。术后6周通过X线片测量髋-膝-踝角(HKA)、股骨远端外侧角和胫骨近端内侧角,以评估下肢对线和假体对线情况。调查患者的满意度以及WOMAC疼痛、僵硬、功能和总分。 结果:18例患者(94.7%)膝关节伸直位内外侧间隙平衡,18例患者(94.7%)屈膝90°时内外侧间隙平衡,19例患者(100%)膝关节伸直位与屈膝90°之间内侧间隙平衡,18例患者(94.7%)膝关节伸直位与屈膝90°之间外侧间隙平衡。平均手术时间为126分钟(范围100 - 200分钟)。平均术中出血量为205 mL(范围100 - 400 mL)。患者随访4 - 8个月,平均6.2个月。术后并发症包括1例下肢深静脉血栓形成和1例脑梗死。X线片显示,平均HKA、股骨远端外侧角和胫骨近端内侧角分别为179.8°(范围178° - 182°)、83.5°(范围80° - 87°)和89.5°(范围87° - 93°)。末次随访时,WOMAC疼痛、僵硬、功能和总分分别为3.6±1.9、0(0,2)、4(2,6)和9(5,10),与术前评分相比有所改善(P<0.05)。12例患者对手术结果非常满意,7例患者对手术结果满意。总体满意度为100%。 结论:Knee 3软件有助于获得良好的间隙平衡和最佳的下肢对线,患者满意度高,短期疗效良好。

相似文献

[1]
[Short-term effectiveness of novel computer navigation system assisted total knee arthroplasty].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021-10-15

[2]
[A prospective randomized controlled trial on the short-term effectiveness of domestic robot-assisted total knee arthroplasty].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021-10-15

[3]
[Early effectiveness of computer navigation-assisted total knee arthroplasty].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021-10-15

[4]
Extra-articular factors of the femur and tibia affecting knee balance in mechanically aligned total knee arthroplasty.

Orthop Traumatol Surg Res. 2022-12

[5]
What Factors Are Associated With Femoral Component Internal Rotation in TKA Using the Gap Balancing Technique?

Clin Orthop Relat Res. 2017-8

[6]
The implications of mechanical alignment on soft tissue balancing in total knee arthroplasty.

Knee Surg Sports Traumatol Arthrosc. 2015-12

[7]
Total Knee Arthroplasty Using Adjusted Restricted Kinematic Alignment for the Treatment of Severe Varus Deformity: Technical Note.

Orthop Surg. 2022-8

[8]
[Early clinical effects of total knee arthroplasty with kinematic alignment assisted by patient-specific instrumentation].

Zhonghua Wai Ke Za Zhi. 2020-6-1

[9]
Precision of Ci-navigated extension and flexion gap balancing in total knee arthroplasty and analysis of potential predictive variables.

Arch Orthop Trauma Surg. 2011-11-11

[10]
[Surgical technique of lateral unicompartmental knee arthroplasty and discussion of the maximum correction value in the treatment of knee valgus deformity].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023-10-15

本文引用的文献

[1]
Computer Navigation-Assisted Knee Replacement Demonstrates Improved Outcome Compared with Conventional Knee Replacement at Mid-Term Follow-up: A Systematic Review and Meta-analysis.

Indian J Orthop. 2020-6-13

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Arthritis Rheumatol. 2021-2

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J Arthroplasty. 2017-9

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