Comparison of the radiological results between fluoroscopy-assisted and navigation-guided total knee arthroplasty
Comparison of the radiological results between fluoroscopy-assisted and navigation-guided total knee arthroplasty
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透视辅助与导航引导全膝关节置换术影像学结果比较
DOI：
10.1007/s00167-008-0682-z
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Jae
中科院分区：
文献类型：
--
作者：
Y. Jung;Han;Ho;K. Song;Jae;Jae
近年来，计算机导航的有效性和准确性得到了证明。但最近的研究大多集中在全膝关节置换术中的冠状排列，对矢状位排列的研究较少。我们回顾比较了35例使用非图像导航系统的TKA和36例使用透视辅助传统技术的TKA的X线片结果。测量平均机械股骨胫角、平均股骨胫骨解剖角度、平均冠状股骨假体角度、平均冠状胫骨假体角度、平均股骨假体矢状角、平均矢状位胫骨假体角度。导航TKA在机械轴偏差、股骨冠状假体夹角、胫骨矢状假体夹角等方面表现出较好的准确性和一致性。两组胫骨假体的冠状位置均可接受。导航全膝关节置换术对机械轴的恢复有明显的促进作用，但对股骨假体矢状位的恢复效果不明显。透视辅助常规全膝关节置换术较导航全膝关节置换术更倾向于在屈曲位置入股骨假体。与传统的透视辅助全膝关节置换术不同，在导航全膝关节置换术中，股骨假体的插入位置比预期的略有伸展。综上所述，尽管在全膝关节置换术中使用导航可以帮助外科医生获得良好的效果，但外科医生仍应了解股骨假体在矢状面内的伸展趋势，以避免前方切迹。
The efficacy and accuracy of computer navigation have been proved during recent years. But most of recent studies focused on the coronal alignment in total knee arthroplasty and less on sagittal alignment. We retrospectively compared the results of the radiographs of 35 primary TKAs using a non-image based navigation system and 36 primary TKAs using fluoroscopy-assisted conventional technique. To compare the radiographic results, the following parameters were measured: mean mechanical femorotibial angle, mean femorotibial anatomical angle, mean coronal femoral component angle, mean coronal tibial component angle, mean sagittal femoral component angle, and mean sagittal tibial component angle. The navigation TKA showed better accuracy and consistency in mechanical axis deviation, coronal femoral component angle, and sagittal tibial component angle. The coronal tibial component position was acceptable in both groups. The navigation TKA markedly improved the restoration of mechanical axis, but not so much in sagittal femoral component position. The fluoroscopy-assisted conventional TKA had a tendency that femoral component was inserted in flexed position than in navigation TKA. Unlike the fluoroscopy-assisted conventional TKA, the femoral component was inserted in slightly extended position in the navigation TKA than expected. In conclusion, even though the use of navigation in TKAs help the surgeon to achieve good results, the surgeon should know the tendency of extension of the femoral component in sagittal plane to avoid anterior notching.