Alling Triine E, Conteh-Meijer Marrigje F, Boerboom Alexander L, Stevens Martin, Reininga Inge H F
Department of Orthopaedics, University Medical Center Groningen University of Groningen Groningen The Netherlands.
Department of Orthopaedics Martini Hospital Groningen Groningen The Netherlands.
J Exp Orthop. 2024 Jul 16;11(3):e12064. doi: 10.1002/jeo2.12064. eCollection 2024 Jul.
Computer-assisted surgery (CAS) during primary total knee arthroplasty (TKA) prosthesis alignment. However, literature on its use during revision TKA (rTKA) is scarce. Moreover, the effect of CAS during rTKA on rotational alignment of the prosthesis has not been described yet. The purpose of this study was to assess the effect of CAS during rTKA, focusing on the number of outliers and coronal, sagittal and rotational prosthetic alignment compared to conventional rTKA.
A prospective cohort study comparing CAS-rTKA with a historical control group (CON-rTKA). The CAS-rTKA group (54 patients/62 knees) underwent rTKA using imageless CAS between 2012 and 2017. The CON-rTKA group (13 patients/23 knees) was operated using the conventional technique between 2002 and 2012. Postoperative alignment was measured using the EOS-2D/3D system (coronal and sagittal planes) and computed tomography scan (rotation).
No significant differences between the CAS-rTKA and CON-rTKA groups were found for coronal and sagittal alignment regarding the mechanical angle of the leg ( = 0.08), mechanical lateral distal femoral angle ( = 0.87), mechanical medial proximal tibial angle ( = 0.40), anatomical proximal posterior tibial angle ( = 0.43) nor femoral ( = 0.80) and tibial rotation ( = 0.15). For the proportions of coronal, sagittal and rotational outliers, no significant differences were found either.
This study showed no evidence that use of CAS during rTKA leads to improved coronal, sagittal or rotational alignment of knee prostheses or a difference of outliers between the groups.
Level III, therapeutic.
计算机辅助手术（CAS）用于初次全膝关节置换术（TKA）时的假体对线。然而，关于其在翻修全膝关节置换术（rTKA）中的应用的文献很少。此外，rTKA中CAS对假体旋转对线的影响尚未见报道。本研究的目的是评估rTKA中CAS的效果，重点关注与传统rTKA相比的异常值数量以及冠状面、矢状面和假体旋转对线情况。
一项前瞻性队列研究，将CAS-rTKA与历史对照组（CON-rTKA）进行比较。CAS-rTKA组（54例患者/62膝）在2012年至2017年间使用无图像CAS进行rTKA。CON-rTKA组（13例患者/23膝）在2002年至2012年间采用传统技术进行手术。术后对线采用EOS-2D/3D系统（冠状面和矢状面）和计算机断层扫描（旋转）进行测量。
在冠状面和矢状面对线方面，CAS-rTKA组和CON-rTKA组在下肢机械角度（=0.08）、机械外侧股骨远端角度（=0.87）、机械内侧胫骨近端角度（=0.40）、解剖学胫骨近端后角度（=0.43）以及股骨（=0.80）和胫骨旋转（=0.15）方面均未发现显著差异。在冠状面、矢状面和旋转异常值的比例方面，也未发现显著差异。
本研究表明，没有证据表明rTKA中使用CAS能改善膝关节假体的冠状面、矢状面或旋转对线，或导致两组间异常值存在差异。
三级，治疗性。
