Department of Orthopedic and Traumatic Surgery, Cheju Halla General Hospital, Jeju Province, Korea.
Department of Orthopaedic Surgery, College of Medicine, Daegu Catholic University, Daegu city, Korea.
Medicine (Baltimore). 2022 Aug 19;101(33):e30085. doi: 10.1097/MD.0000000000030085.
To compare femoral sagittal axis between navigated total knee arthroplasty (TKA) and conventional TKA. A total of 136 cases were assigned to group 1 (navigated TKA) and 77 cases were assigned to group 2 (conventional TKA). Specifically, this study targeted patients with degenerative osteoarthritis. Only patients with primary TKA were analyzed. Hip knee ankle angle and lateral femoral bowing were measured using preoperative scanogram. Anterior femoral bowing was measured using preoperative femoral lateral X rays. The presence of anterior femoral notching and the insertion angle of the femoral implant with respect to the anatomical sagittal plane of the distal femur were checked using postoperative lateral knee X rays. Student t-test was used to compare the difference in the position of the sagittal plane of the femoral implant between the navigated TKA group and the conventional TKA group. When comparing the 2 groups, the sagittal axis of the femoral implant was more extended than the anatomical sagittal plane axis of the distal femur in group 1 than in group 2 (P = .01). There was a significant negative correlation between the value of anterior femoral bowing and the degree of flexion to the sagittal plane of the femoral implant in group 1 (correlation coefficient: -0.40, P = .01). The occurrence of anterior femoral notching was significantly higher in group 1 than in group 2. During navigated TKA, imageless navigation does not consider the anatomical variation of the femoral shaft. Therefore, surgeons should take into consideration that when performing navigated TKA, a femoral implant could be inserted more extended for the anatomical sagittal axis of the distal femur than for the conventional TKA. Also, surgeon should know that the degree of extension insertion of the femoral implant increases as femoral anterior bowing increases.
比较导航全膝关节置换术（TKA）和传统 TKA 的股骨矢状轴。共有 136 例患者被分配到组 1（导航 TKA），77 例患者被分配到组 2（传统 TKA）。具体来说，本研究针对的是退行性骨关节炎患者。仅分析了原发性 TKA 患者。使用术前扫描图测量髋膝踝角和外侧股弓。使用术前股骨外侧 X 射线测量股骨前弓。使用术后膝关节外侧 X 射线检查股骨前切迹的存在和股骨植入物相对于股骨远端解剖矢状面的插入角度。使用 Student t 检验比较导航 TKA 组和传统 TKA 组股骨植入物矢状面位置的差异。在比较两组时，与组 2 相比，组 1 中股骨植入物的矢状轴比股骨远端解剖矢状面轴更伸展（P =.01）。在组 1 中，股骨前弓的数值与股骨植入物向矢状面的弯曲程度呈显著负相关（相关系数：-0.40，P =.01）。与组 2 相比，组 1 中股骨前切迹的发生率明显更高。在导航 TKA 中，无图像导航不考虑股骨干的解剖变异。因此，外科医生应该考虑到，在进行导航 TKA 时，股骨植入物的插入角度可能比传统 TKA 更伸展，以适应股骨远端的解剖矢状轴。此外，外科医生应该知道，随着股骨前弓的增加，股骨植入物的伸展插入角度增加。
