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术前三维CT规划是否有助于预测自动机器人全膝关节置换术(RA-TKA)中假体尺寸的确定和对线?

Does preoperative 3D CT planning helps in predicting the component size determination and alignment in automatic robotic total knee arthroplasty (RA-TKA).

作者信息

Bhor Pramod, Pawar Sawankumar, Kutumbe Dnyanada, Vatkar Arvind, Kale Sachin, Jagtap Rahul

机构信息

Fortis Hiranandani Hospitals, Mini Sea Shore Road, Juhu Nagar, Sector 10A, Vashi, Navi Mumbai, Maharashtra, 400703, India.

出版信息

J Orthop. 2023 Jul 23;43:25-29. doi: 10.1016/j.jor.2023.07.011. eCollection 2023 Sep.

Abstract

PURPOSE

Image-based Robotic Total knee Arthroplasty (RA-TKA)was developed with the purpose of enhancing the accuracy in determining the component sizes preoperatively and helping surgeons in minimizing errors and improve patient outcomes. The research aims to find the reliability of robotic-assisted TKR based on images in determining the correct component sizes using preoperative three-dimensional (3D) computer tomography.

METHOD

After ethical approval, we conducted a prospective study from March 2022 to December 2022. A total of 100 knees underwent image-based RA-TKA having grade 4 Osteoarthritis knee (Kellegren Lawrence classification). A single senior surgeon performed on all patients. Postoperative implant sizes and fit were assessed by five radiographic markers by an independent observer.

RESULTS

In our study, we found the mean age was (64.96 ± 7.3) years, with female to male ratio of 43:22. The preoperative 3D CT accuracy is 100% for femoral component sizing and 97% for the tibial component. There was a statistically significant improvement in varus deformity from preoperative 7.370 ± 3.70° to 1.24 0 ± 0.910° after surgery., p = 0.001. Improvement in flexion deformity correction was from preoperative 6.50 ± 6.30 to postoperative 1.640 ± 1.770, p = 0.001.

CONCLUSION

Our study concludes that the use of pre-operative 3D CT helps in predicting the component sizes, minimizes surgical time, and enhances implant position accuracy, as well as improves postoperative limb alignment in the coronal and sagittal planes.

摘要

目的

开展基于图像的机器人全膝关节置换术(RA-TKA),旨在提高术前确定假体组件尺寸的准确性,帮助外科医生减少误差并改善患者预后。本研究旨在探讨基于图像的机器人辅助全膝关节置换术在使用术前三维(3D)计算机断层扫描确定正确假体组件尺寸方面的可靠性。

方法

经伦理批准后,我们于2022年3月至2022年12月进行了一项前瞻性研究。共有100例患有4级骨关节炎膝关节(凯尔格伦-劳伦斯分类)的患者接受了基于图像的RA-TKA手术。所有手术均由一位资深外科医生完成。术后植入物尺寸和适配情况由一名独立观察者通过五个放射学标记进行评估。

结果

在我们的研究中,发现平均年龄为(64.96±7.3)岁,女性与男性比例为43:22。术前3D CT对股骨组件尺寸的测量准确率为100%,对胫骨组件的准确率为97%。术后内翻畸形从术前的7.370±3.70°显著改善至1.240±0.910°,p = 0.001。屈曲畸形矫正从术前的6.50±6.30改善至术后的1.640±1.770,p = 0.001。

结论

我们的研究得出结论,术前使用3D CT有助于预测假体组件尺寸,减少手术时间,提高植入物位置准确性,并改善术后肢体在冠状面和矢状面的对线情况。

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