Zhao R, Liu Y Q, Tian H
Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Aug 18;55(4):658-664. doi: 10.19723/j.issn.1671-167X.2023.04.015.
To explore the training ability of pad to guide the balance of soft tissue by drawing cumulative sum (CUSUM) control chart total knee arthroplasty (TKA) sensor.
The data of 73 knees of TKA assisted by electronic gasket initially completed by a senior physician were analyzed retrospectively. There were 8 males (8 knees) and 52 females (65 knees), with an average age of (67.5±5.9) years (57-82 years). The balance of the internal and external space of knee joint was measured at 0°, 45°, 90°, and 120°, in order to observe the pressure distribution of the medial and la-teral compartments, and CUSUM learning curve was drawn.
In 0° extension, the medial pressure was higher than the lateral ( < 0.01), when flexion began, the medial and lateral pressures decreased, and became stable and approximately equal during 45°-120°. In the learning curve, by knee 34, CUSUM 0° curve crossed the acceptable control line from above, which showed that it was easy to grasp the soft tissue balance at 0° position through sensor learning. CUSUM 45° curve was above the unacceptable control line in the end, which meant that it was difficult to grasp the technique at the mid-flexion angle. CUSUM 90° and 120° crossed the acceptable control line from above by knee 68 and 57 respectively, which showed that the technique of balance could be improved with the aid of more cases.
The electronic pressure sensor can effectively guide the soft tissue balance in TKA. The learning process is simple and does not increase the risk of complications. It can be used as a tool for learning TKA soft tissue balance technology to guide joint surgeons to further master or improve the soft tissue balance technology.
通过绘制累积和（CUSUM）控制图，探讨垫引导全膝关节置换术（TKA）传感器软组织平衡的训练能力。
回顾性分析由一名资深医师最初完成的73例电子垫片辅助TKA膝关节的数据。男性8例（8膝），女性52例（65膝），平均年龄（67.5±5.9）岁（57 - 82岁）。在0°、45°、90°和120°测量膝关节内外侧间隙平衡，以观察内外侧间室的压力分布，并绘制CUSUM学习曲线。
在0°伸直位时，内侧压力高于外侧（<0.01），开始屈曲时，内外侧压力均下降，在45° - 120°期间变得稳定且大致相等。在学习曲线中，到第34膝时，CUSUM 0°曲线从上方穿过可接受控制线，这表明通过传感器学习很容易掌握0°位置的软组织平衡。CUSUM 45°曲线最终位于不可接受控制线之上，这意味着在屈膝中间角度难以掌握该技术。CUSUM 90°和120°分别在第68膝和第57膝时从上方穿过可接受控制线，这表明借助更多病例可以提高平衡技术。
电子压力传感器可有效指导TKA中的软组织平衡。学习过程简单，且不增加并发症风险。它可作为学习TKA软组织平衡技术的工具，以指导关节外科医生进一步掌握或改进软组织平衡技术。
