Wangjing Hospital of CACMS, Beijing, China.
Orthop Surg. 2023 Nov;15(11):2786-2793. doi: 10.1111/os.13842. Epub 2023 Aug 14.
A micro-electromechanical system (MEMS) was developed based on spatial alignment and navigation technology to assist femoral extramedullary alignment osteotomy (FEAO) in total knee arthroplasty (TKA). The system can locate and adjust the femoral distal condylar osteotomy (FDCO) to obtain a better femoral prosthesis placement. It is a portable navigation device and provides an innovative approach for FDCO.
Sixty patients who suffered from severe knee osteoarthritis who underwent unilateral TKA from May 14, 2021 to May 30, 2022 were randomly divided into a MEMS-FEAO group and a conventional femoral intramedullary alignment osteotomy (FIAO) group, with 30 cases in each group for a controlled retrospective study. The hip-knee-ankle angle (HKAA) of the lower limb was measured before and after surgery, the femoral valgus angle (FVA) was measured preoperatively, and the femoral prosthesis valgus angle (FPVA) and the femoral prosthesis flexion angle (FPFA) were measured postoperatively following computed tomography imaging protocols. Measurement data is statistically described as mean ± standard deviation c. The count data is described by frequency (constituent ratio) using the rank sum test.
A total of 6.7% (2/30) of FEAO compared to 20.0% (6/30) of FIAO cases were postoperative deviations where the HKAA exceeded ±3° of neutral alignment (p < 0.05). The postoperative HKAA was 178.74° ± 1.56° versus 176.64° ± 3.39° (p < 0.05), the HKAA deviation was 1.25° ± 1.56° versus 3.36° ± 3.40° (p < 0.05), and the FPFA was 4.85° ± 2.46° versus 6.60° ± 1.86°(p < 0.05). Therefore, the differences were all statistically significant between the two groups. However, the FPVA was -0.59° ± 2.73° versus -0.80° ± 2.85° (p > 0.05), and there was no statistical significance between the two groups.
The MEMS-FEAO system can improve the accurate alignment and can be utilized as a locator to obtain the best femoral prosthesis placement in TKA and significantly reduce the rate of poor force line of the lower limb.
基于空间对准和导航技术开发了一种微机电系统 (MEMS)，以辅助全膝关节置换术 (TKA) 中的股骨髁外髓腔对线截骨术 (FEAO)。该系统可以定位和调整股骨远端髁截骨术 (FDCO)，以获得更好的股骨假体放置。它是一种便携式导航设备，为 FDCO 提供了一种创新方法。
回顾性分析 2021 年 5 月 14 日至 2022 年 5 月 30 日期间接受单侧 TKA 的 60 例严重膝骨关节炎患者的临床资料，采用随机数字表法分为 MEMS-FEAO 组和常规股骨髓内对线截骨术 (FIAO) 组，每组 30 例。测量术前、术后下肢髋膝踝角 (HKAA)，测量术前股骨外翻角 (FVA)，术后根据 CT 成像方案测量股骨假体外翻角 (FPVA)和股骨假体弯曲角 (FPFA)。计量资料采用均数±标准差 c 表示，计数资料采用秩和检验描述构成比。
FEAO 术后有 6.7% (2/30)的病例出现 HKAA 偏离中立位 ±3°，而 FIAO 术后有 20.0% (6/30)的病例出现 HKAA 偏离中立位 (p<0.05)。术后 HKAA 为 178.74°±1.56°，而术前为 176.64°±3.39°(p<0.05)，HKAA 偏差为 1.25°±1.56°，而术前为 3.36°±3.40°(p<0.05)，FPFA 为 4.85°±2.46°，而术前为 6.60°±1.86°(p<0.05)。因此，两组间差异均有统计学意义。但是，FPVA 为-0.59°±2.73°，而术前为-0.80°±2.85°(p>0.05)，两组间无统计学意义。
MEMS-FEAO 系统可以提高截骨的准确性，并可作为定位器，在 TKA 中获得最佳的股骨假体放置位置，显著降低下肢力线不良的发生率。
