de Andrés-Torán Ana, Padilla-Eguiluz Norma G, Hernández-Esteban Pablo, Gómez-Barrena Enrique
Servicio de Cirugía Ortopédica y Traumatología, Hospital La Paz-IdiPaz, 28046 Madrid, Spain.
Departamento de Cirugía, Facultad de Medicina, Universidad Autónoma de Madrid, 28029 Madrid, Spain.
J Clin Med. 2025 Jan 10;14(2):429. doi: 10.3390/jcm14020429.
: Surgical accuracy in total knee replacement (TKR) may vary with the surgeon, the patient preoperative deformity, and the guiding system to perform the procedure. Navigation systems attempt to increase the intraoperative information the surgeon requires to make the appropriate decisions, sometimes associating cumbersome procedures and unclear effectiveness to place the implant more precisely than conventional instruments. : We conducted a retrospective case-control study with prospective data collection of radiographic measurements (alignment, joint line and patellar height) in a sample of 100 consecutive patients receiving TKR Optetrak Logic PS, either with standard surgical technique with Trulion Instrumentation ( = 59) or with the Guided Personalized Surgery (GPS) system ( = 41). : The GPS group improved the alignment of the mechanical Lateral Distal Femoral Angle (mLDFA) in 1.6° compared to the control ( = 0.003), but not evident in the mechanical Medial Proximal Tibial Angle (mMPTA) ( = 0.132). The GPS system achieved a normal patellar height in 98% of cases, according to the Blackburne-Peel Index (BP), compared to 71% in the control group ( = 0.002). This was obtained in the femoral side, as measured in the Epicondylar Ratio (ER) ( = 0.004). A lower dispersion of postoperative measurements was observed in the GPS group in comparison with the control, being statistically significant in mMPTA ( = 0.000), CD-Index ( = 0.011), IS-Index ( = 0.002), mIS-Index ( = 0.008), BP-Index ( = 0.011), and ER ( = 0.004). : Better post-surgical restoration of joint line and patellar height is observed in surgeries performed with the GPS system, as well as a tendency to more accurate mechanical alignment and lower inter-patient variability, suggesting higher reproducibility.
全膝关节置换术（TKR）的手术精度可能因外科医生、患者术前畸形情况以及进行该手术的引导系统而异。导航系统试图增加外科医生做出适当决策所需的术中信息，有时会将繁琐的操作和不明确的有效性与比传统器械更精确地放置植入物联系起来。我们进行了一项回顾性病例对照研究，前瞻性收集了100例连续接受TKR Optetrak Logic PS的患者样本的影像学测量数据（对线、关节线和髌骨高度），这些患者要么采用Trulion器械的标准手术技术（n = 59），要么采用引导式个性化手术（GPS）系统（n = 41）。与对照组相比，GPS组的机械性股骨外侧远端角（mLDFA）对线改善了1.6°（P = 0.003），但在机械性胫骨近端内侧角（mMPTA）方面不明显（P = 0.132）。根据Blackburne-Peel指数（BP），GPS系统在98%的病例中实现了正常的髌骨高度，而对照组为71%（P = 0.002）。这是在股骨侧获得的，以髁上比率（ER）衡量（P = 0.004）。与对照组相比，GPS组术后测量的离散度更低，在mMPTA（P = 0.000）、CD指数（P = 0.011）、IS指数（P = 0.002）、mIS指数（P = 0.008）、BP指数（P = 0.011）和ER（P = 0.004）方面具有统计学意义。在使用GPS系统进行的手术中，观察到关节线和髌骨高度的术后恢复更好，以及机械对线更精确和患者间变异性更低的趋势，表明具有更高的可重复性。
