摘要
目的对比研究计算机导航系统辅助下间隙平衡技术在全膝关节置换术中的应用价值。方法选取2018年1-6月的63例原发性膝关节骨性关节炎的患者行全膝关节置换术,分为计算机导航辅助下间隙平衡技术组(31例)和测量截骨技术组(32例)。记录计算机导航辅助下间隙平衡技术组术中屈伸间隙内外侧韧带张力大小,测量并比较两组术后下肢冠状面机械轴力线,手术切口长度,手术时间,术中出血量,术后引流量,术后并发症发生率,术后1、6、12个月的视觉模拟评分(Vas疼痛评分)及膝关节KSS评分等指标。结果计算机导航间隙平衡技术组的手术时间长于测量截骨技术组(P<0.05),切口长度、术中出血量、术后引流量、术后并发症发生率两组比较差异无统计学意义(P>0.05)。计算机导航辅助下间隙平衡技术组术后下肢冠状面机械轴力线(0.63±0.54)°优于测量截骨技术组[(1.98±0.52)°,P<0.05];计算机导航辅助下间隙平衡技术组术后1个月的Vas疼痛评分(3.53±0.51)分优于测量截骨技术组[(4.24±0.49)分,P<0.05];计算机导航下间隙平衡技术组术后1个月KSS功能评分存在优于测量截骨技术组的趋势,但差异无统计学意义(P>0.05);术后6个月和12个月的Vas评分和KSS功能评分两组差异无统计学意义(P>0.05)。计算机导航辅助下间隙平衡技术组中31例患者屈伸间隙内外侧韧带张力范围在70~95 N,平均84 N。结论计算机导航辅助下间隙平衡技术能精确术中截骨,提高全膝关节置换术的手术精准度,术后患者疼痛及功能在短期内恢复较好。
Objective To investigate the value of gap balance technique guided by computer-assisted navigation in total knee replacement. Methods A total of 63 patients with primary knee osteoarthritis and underwent total knee replacement from January to June 2018 were recruited in this study. They were randomly divided into experimental group(n=31, gap balance technique guided by computer-assisted navigation) and control group(n=31, osteotomy technique). The tension of medial and lateral ligaments in the flexion and extension space was recorded, and the limb alignment, incision length, operative time, blood loss volume, drainage volume, incidence of postoperative complications, and visual analogue scale(Vas) score and knee society knee score(KSS) in 1, 6 and 12 months after operation were recorded and compared between 2 groups. Results The operative time in experimental group was significantly longer than that in the control group(P<0.05), but there were no significant differences in incision length, blood loss, drainage volume and incidence of postoperative complications between 2 groups(P>0.05). The limb alignment was better in the experimental group than the control group [(0.63±0.54)° vs(1.98±0.52)°, P<0.05]. In 1 month after operation, the experimental group achieved significantly better Vas score(3.53±0.51 vs 4.24±0.49, P<0.05), but similar KSS score(69.3±5.1 vs 67.5±3.7, P>0.05) when compared with the control group. But, in 6 and 12 months after surgery, no statistic differences were seen in the above 2 scores(P>0.05). For the patients from the experimental group, the tension of medial and lateral ligaments in the flexion and extension space ranged from 70 to 95 N, with an average of 84 N. Conclusion Gap balance technique guided by computer-assisted navigation can improve the accuracy of osteotomy in total knee replacement, with postoperative benefits of significantly reducing pain and rapid recovery during the early postoperative period, but having no obvious effect on outcome after 1 year’s follow-up.
作者
谢川江
邱洪九
李帅峰
石岭
朱纪峰
王子明
熊雁
XIE Chuanjiang;QIU Hongjiu;LI Shuaifeng;SHI Ling;ZHU Jifeng;WANG Ziming;XIONG Yan(Department of Orthopedics,Daping Hospital,Army Medical University(Third Military Medical University),Chongqing,400042,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2019年第21期2120-2126,共7页
Journal of Third Military Medical University
