Minimally invasive total knee arthroplasty: comparison of jig-based technique versus computer navigation for clinical and alignment outcome
Minimally invasive total knee arthroplasty: comparison of jig-based technique versus computer navigation for clinical and alignment outcome
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DOI：
10.1007/s00167-010-1253-7
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发表时间：
2011-06-01
影响因子：
3.8
通讯作者：
Sudo, Akihiro
中科院分区：
文献类型：
--
作者：
Hasegawa, Masahiro;Yoshida, Kakunoshin;Sudo, Akihiro
下肢的正确对线和假体的正确定位是全膝关节置换术（TKA）获得良好长期结局的重要因素。引入了计算机辅助导航系统，以提高部件对准精度。本研究的三个主要假设是，导航患者与基于夹具的患者相比将显示以下结果：（1）临床结局无差异。(2)在冠状面和矢状面更好的对齐。(3)更好的部件旋转定位：作者评价了100例使用无图像计算机辅助导航系统（n = 50）或基于夹具的技术（n = 50）进行微创TKA的患者。术后6个月，临床和放射学评估采用全长站立前后位和侧位X线片和膝关节CT扫描进行。膝关节协会膝关节评分，功能评分和活动范围在术后两组之间具有可比性。导航组中额叶胫股角在理想值+/- 3A度范围内的患者百分比显著高于夹具组（分别为94% vs. 78%; P = 0.041）。两组之间在冠状面和矢状面以及股骨或胫骨部件的旋转对齐方面没有显著差异。与基于夹具的TKA相比，计算机辅助TKA结合微创手术入路时，可以更好地矫正腿部对齐。
Correct alignment of the leg and positioning of the components are important factors in good long-term outcome of total knee arthroplasty (TKA). Computer-assisted navigation systems were introduced to improve component alignment accuracies. The three main hypotheses of this study were that the navigated compared to jig-based patient will show the following: (1) No difference in clinical outcomes. (2) Better alignment in the frontal and sagittal plane. (3) Better rotational positioning of components.The authors evaluated 100 patients who had minimally invasive TKA using either an image-free computer-assisted navigation system (n = 50) or a jig-based technique (n = 50). Six months postoperatively, clinical and radiological evaluations were performed using full-length standing anteroposterior and lateral radiographs and CT scans of the knee.Knee Society knee score, function score, and range of motion were comparable in the two groups after surgery. The percentage of patients with a frontal tibiofemoral angle within +/- 3A degrees of the ideal was significantly higher in the navigated group than in the jig-based group (94% vs. 78%, respectively; P = 0.041). No significant differences were found between groups in terms of the frontal and sagittal planes as well as rotational alignment of the femoral or tibial components.Computer-assisted TKA gives a better correction of alignment of the leg compared with jig-based TKA when combined with a minimally invasive surgical approach.