Patel Jeegar M, Yadav Krishan, Daga Rohit G, Sadaria Mohan
Department of Orthopaedics, RKDF Medical College, Bhopal, Madhya Pradesh, India.
Madhubani Medical College, Madhubani, Bihar, India.
J Pharm Bioallied Sci. 2023 Jul;15(Suppl 2):S1160-S1163. doi: 10.4103/jpbs.jpbs_181_23. Epub 2023 Apr 28.
The goal of this research is to determine how well OrthAlign, a novel portable navigation system for total knee replacement, helps surgeons make accurate incisions. When comparing OrthoAlign, a portable accelerometer-based technique, to the gold standard of extramedullary jigs, the results are promising. This study aimed to evaluate the accuracy of distal femoral and proximal tibial cuts in total knee arthroplasty.
This research analyzed data from a prospective cohort study. Participants in the study all had resections of the proximal tibia and distal femur using the OrthAlign portable navigations device. Total knee arthroplasty (TKA) patients throughout the same time period who used traditional medullary alignment jigs were included as a control group. Before and after surgery, full-length standing stitch radiographs of the patient's lower limbs were acquired so that the alignment of their knees could be assessed.
In the mechanical alignment exam done following the surgery, the OrthAlign group performed substantially better than the control group, although the difference was not statistically significant. Patients treated with OrthoAlign had considerably improved alignment of the tibial components in the coronal plane compared to those treated manually. When comparing the OrthAlign cohort to the conventional cohort, average sagittal plane alignment of tibial components was significantly different. Yet, when comparing femoral alignment after surgery, neither the mechanical alignment nor the OrthAlign groups fared better. Furthermore, there was no statistically significant difference between the two groups when it comes to the occurrence of outliers with postoperative mechanical axis alignment >3 degrees or tibial alignment in the coronal plane >2 degrees. Compared to OrthAlign, conventional alignment methods resulted in a higher percentage of postoperative tibial alignment in the sagittal plane (greater than 2 degrees). Patients whose femurs were misaligned by more than 2 degrees after surgery favored the OrthAlign method, albeit this was not statistically different from the control group. There was a significant reduction in tourniquet time for patients using OrthoAlign compared to those using mechanical alignment devices.
本研究的目的是确定一种用于全膝关节置换的新型便携式导航系统OrthAlign在帮助外科医生进行精确切口方面的效果如何。将基于便携式加速度计的技术OrthAlign与髓外定位器的金标准进行比较时，结果很有前景。本研究旨在评估全膝关节置换术中股骨远端和胫骨近端截骨的准确性。
本研究分析了一项前瞻性队列研究的数据。研究参与者均使用OrthAlign便携式导航设备进行了胫骨近端和股骨远端的切除。同一时期使用传统髓内定位夹具的全膝关节置换（TKA）患者作为对照组。在手术前后，获取患者下肢的全长站立拼接X线片，以便评估其膝关节的对线情况。
在术后进行的机械对线检查中，OrthAlign组的表现明显优于对照组，尽管差异无统计学意义。与手动治疗的患者相比，接受OrthAlign治疗的患者胫骨组件在冠状面的对线有显著改善。将OrthAlign队列与传统队列进行比较时，胫骨组件的平均矢状面对线有显著差异。然而，在比较术后股骨对线时，机械对线组和OrthAlign组的表现都没有更好。此外，当术后机械轴对线>3度或冠状面胫骨对线>2度的异常值出现时，两组之间没有统计学上的显著差异。与OrthAlign相比，传统对线方法导致矢状面术后胫骨对线的百分比更高（大于2度）。术后股骨对线偏差超过2度的患者更倾向于OrthAlign方法，尽管这与对照组在统计学上没有差异。与使用机械对线设备的患者相比，使用OrthAlign的患者止血带时间显著缩短。
