Sarzaeem Mohammad Mahdi, Amouzadeh Farzad, Salehi Bentolhoda, Movahedinia Mohammad, Soleimani Mohammad
Imam Hossien Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran.
Indian J Orthop. 2023 Nov 15;57(12):2088-2094. doi: 10.1007/s43465-023-01023-0. eCollection 2023 Dec.
Orthopedic surgeons favor an intramedullary guiding system on the femoral component during total knee arthroplasty (TKA); nevertheless, improper positioning of the entry point affects the final alignment. We have designed a new femoral cutting system for TKA that uses the distal and posterior femoral condyles as reference points for the setting of the cutting system regardless of the femoral canal. This study aims to evaluate the outcomes of this new guiding system.
We enrolled a series of 75 consecutive knees undergoing TKA. The alpha, gamma, and hip-knee-ankle (HKA) angles were assessed three months postoperatively. Also, surgical time and intraoperative blood loss were recorded for all patients.
Fifteen patients underwent TKA using the mechanical alignment (MA) strategy, and 60 underwent kinematically aligned (KA) TKA. Both groups showed normal coronal and sagittal alignment 3 months postoperatively. The mean intraoperative blood loss was 213.11 ± 52.73 ml, which was not different between the two groups (n.s.). The mean surgical time was 43.12 ± 11.62 min, which was significantly shorter in the KA-TKA (41.11 ± 3.77 min) than in the MA-TKA (49.34 ± 4.56 min) ( < 0.001).
Using the new guiding system with good femoral alignment, we introduced the easily palpable and available condylar surface as a new landmark for cutting the distal femur in TKA.
IV.
在全膝关节置换术（TKA）中，骨科医生倾向于在股骨部件上使用髓内导向系统；然而，入口点定位不当会影响最终对线。我们设计了一种用于TKA的新型股骨切割系统，该系统使用股骨远端和后髁作为切割系统设置的参考点，而不考虑股骨髓腔。本研究旨在评估这种新型导向系统的效果。
我们纳入了连续75例接受TKA的膝关节。术后三个月评估α、γ和髋-膝-踝（HKA）角。此外，记录所有患者的手术时间和术中失血量。
15例患者采用机械对线（MA）策略进行TKA，60例患者采用运动学对线（KA）TKA。两组术后3个月均显示正常的冠状面和矢状面对线。平均术中失血量为213.11±52.73ml，两组间无差异（无统计学意义）。平均手术时间为43.12±11.62分钟，KA-TKA组（41.11±3.77分钟）明显短于MA-TKA组（49.34±4.56分钟）（<0.001）。
使用具有良好股骨对线的新型导向系统，我们引入了易于触及且可用的髁表面作为TKA中股骨远端切割的新标志。
IV级。
