Kane Matthew C, Cates Harold E, Chang Iou-Ren
Surgery, East Tennessee State University Quillen College of Medicine, Johnson City, USA.
Orthopedic Surgery, Tennessee Orthopedic Foundation for Education and Research, Knoxville, USA.
Cureus. 2024 Sep 6;16(9):e68769. doi: 10.7759/cureus.68769. eCollection 2024 Sep.
The importance of proper prosthetic placement has been confirmed in numerous studies. The objective of this study was to compare the planned resection angles to the verified intraoperative angles of femoral and tibial varus/valgus, tibial slope, and femoral flexion for each total knee performed using intramedullary (IM) cut guides for both distal femur and proximal tibia cuts. A total of 1,000 total knee arthroplasties (TKAs) were evaluated for this study. Intraoperative cut-check technology was used to show real-time validation of these resection angles. Assuming an acceptable range of within 2° of the planned cuts, results show the femoral varus/valgus angles were 75% accurate, the femoral flexion angles were 50.8% accurate, the tibial cuts were 95.2% accurate in the coronal plane, and the tibial slope was the least accurate with only 50.3% within the acceptable range. This showed that IM guides are reasonably accurate in producing desired angles in the coronal plane but less accurate in the sagittal plane, with a greater number of outliers in femoral flexion and posterior slope. Surgeons need to be aware of potential cutting errors when using IM guides as they affect the overall alignment of the implant, and real-time verification technology is available to verify the accuracy of the cuts.
适当的假体放置的重要性已在众多研究中得到证实。本研究的目的是比较使用股骨远端和胫骨近端髓内（IM）截骨导向器进行的每例全膝关节置换术中计划的截骨角度与术中验证的股骨和胫骨内翻/外翻、胫骨坡度以及股骨屈曲角度。本研究共评估了1000例全膝关节置换术（TKA）。术中截骨检查技术用于实时验证这些截骨角度。假设计划截骨角度在2°以内为可接受范围，结果显示股骨内翻/外翻角度的准确率为75%，股骨屈曲角度的准确率为50.8%，胫骨截骨在冠状面的准确率为95.2%，而胫骨坡度的准确率最低，只有50.3%在可接受范围内。这表明IM导向器在冠状面产生所需角度时相当准确，但在矢状面则不太准确，在股骨屈曲和后坡度方面有更多异常值。外科医生在使用IM导向器时需要意识到潜在的截骨误差，因为它们会影响植入物的整体对线，并且有实时验证技术可用于验证截骨的准确性。
