A prospective randomised controlled study of patient-specific cutting guides compared with conventional instrumentation in total knee replacement
A prospective randomised controlled study of patient-specific cutting guides compared with conventional instrumentation in total knee replacement
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DOI：
10.1302/0301-620x.95b3.29903
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发表时间：
2013-03-01
影响因子：
4.6
通讯作者：
Pornrattanamaneewong, C.
中科院分区：
文献类型：
--
作者：
Chareancholvanich, K.;Narkbunnam, R.;Pornrattanamaneewong, C.
患者专用切割导向器(PSCG)旨在提高全膝关节置换术(TKR)对中的准确性。我们比较了使用PSCG和传统器械进行TKR后肢体对齐和假体定位的准确性。共有80名患者随机接受了TKR，并评估了放射学结果和围手术期因素，如手术时间。在胫股角度或股骨假体对齐方面，两组之间没有显著差异。尽管PSCG组的胫骨假体比传统组更接近中性，但差异很小(89.8°(SD1.2)vs90.5°(SD1.6)；p=0.030)。这项新技术将截骨时间平均缩短了3.6min(p<；0.001)，手术时间平均缩短了5.1min(p=0.019)，而在术后失血量(p=0.528)和输血量(p=0.789)方面没有明显差异。这项研究表明，PSCG和传统器械都能恢复肢体对齐，并以类似的精度放置假体。PSCG在排列一致性或手术时间方面的最小优势不太可能与临床相关。引用本文：bone Joint J 2013；95-B：354-9。
Patient-specific cutting guides (PSCGs) are designed to improve the accuracy of alignment of total knee replacement (TKR). We compared the accuracy of limb alignment and component positioning after TKR performed using PSCGs or conventional instrumentation. A total of 80 patients were randomised to undergo TKR with either of the different forms of instrumentation, and radiological outcomes and pen-operative factors such as operating time were assessed. No significant difference was observed between the groups in terms of tibiofemoral angle or femoral component alignment. Although the tibial component in the PSCGs group was measurably closer to neutral alignment than in the conventional group, the size of the difference was very small (89.8 degrees (SD 1.2) vs 90.5 degrees (SD 1.6); p = 0.030). This new technology slightly shortened the bone-cutting time by a mean of 3.6 minutes (p < 0.001) and the operating time by a mean 5.1 minutes (p = 0.019), without tangible differences in post-operative blood loss (p = 0.528) or need for blood transfusion (p = 0.789). This study demonstrated that both PSCGs and conventional instrumentation restore limb alignment and place the components with the similar accuracy. The minimal advantages of PSCGs in terms of consistency of alignment or operative time are unlikely to be clinically relevant. Cite this article: Bone Joint J 2013;95-B:354-9.