Preliminary experience with the patient-specific templating total knee arthroplasty.
Preliminary experience with the patient-specific templating total knee arthroplasty.
复制标题
患者特异性模板全膝关节置换术的初步经验。
DOI：
10.3109/17453674.2012.711700
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发表时间：
2012-08
影响因子：
3.7
通讯作者：
Kort NP
中科院分区：
文献类型：
--
作者：
Boonen B;Schotanus MG;Kort NP
患者特异性模板全膝关节置换术（TKA）是一种使用一次性导尿管的全膝关节置换术对准的新方法。我们介绍了使用这种技术进行手术的前40例连续患者的结果。在这项病例对照研究中，我们比较了40例使用患者特异性模板对齐技术的tka患者的出血量、手术时间和对齐情况，并将其与使用常规髓内对齐技术的匹配对照组患者的数据进行了比较。在站立、长腿和标准侧位数字x线片上测量腿部机械轴的对齐以及单个假体部件的屈伸和内翻。测定异常值（bb0.3˚）的比例。模板tka的平均机械轴为181°，异常分数为0.3；常规tka的平均机械轴为179°，异常分数为0.5。模板式tka股骨假体额平面异常值为0.05，传统tka为0.4，胫骨假体额平面异常值为0.2和0.2。在模板tka和常规tka中，股骨假体矢状面异常值分别为0.4和0.9，胫骨假体矢状面异常值分别为0.4和0.6。与髓内对齐TKA相比，模板TKA平均手术时间缩短10分钟，出血量减少60 mL。与髓内对齐TKA相比，患者特异性模板TKA显示出更高的对齐准确性，并且在失血量和手术时间方面略有减少，但异常值的比例相对较高。需要更大的随机对照试验来进一步评估该技术，并确定患者特异性模板对齐技术在TKA中的未来作用。
Patient-specific templating total knee arthroplasty (TKA) is a new method for alignment of a total knee arthroplasty that uses disposable guides. We present the results of the first 40 consecutive patients who were operated on using this technique. In this case-control study, we compared blood loss, operation time, and alignment of 40 TKAs performed using a patient-specific templating alignment technique with values from a matched control group of patients who were operated on by conventional intramedullary alignment technique. Alignment of the mechanical axis of the leg and flexion/extension and varus/valgus of the individual prosthesis components were measured on standing, long-leg, and standard lateral digital radiographs. The fraction of outliers (> 3˚) was determined. Mean mechanical axis of templating TKAs was 181° with a fraction of outliers of 0.3, and mean mechanical axis of conventional TKAs was 179˚ (outlier fraction 0.5). Fraction of outliers in the frontal plane for femoral components was 0.05 in the templating TKAs and 0.4 in the conventional TKAs, and for tibial components the corresponding values were 0.2 and 0.2. In the templating TKAs and conventional TKAs, fraction of outliers in the sagittal plane was 0.4 and 0.9, respectively, for femoral components and 0.4 and 0.6 for tibial components. Mean operation time was 10 min shorter and blood loss was 60 mL less for templating TKA than for intramedullary-aligned TKAs. Patient-specific templating TKA showed improved accuracy of alignment and a small reduction in blood loss and operating time compared to intramedullary-aligned TKA, but the fraction of outliers was relatively high. Larger RCTs are needed for further evaluation of the technique and to define the future role of patient-specific template alignment techniques for TKA.