摘要
目的探讨便携式导航(PAD)和传统器械(CI)在膝外翻患者全膝关节置换术(TKA)术后下肢力线对准和假体位置的差异。方法回顾性分析北京大学第三医院骨科某单一术者在2017年1月至2020年12月49例行TKA的膝关节外翻患者的临床资料,其中男5例,女44例,年龄(67.2±7.0)岁。根据手术方式分为PAD组和CI组,分析两组患者一般资料、术前力线参数及术后力线参数的差异。结果共纳入49例患者(PAD组25例,CI组24例)。两组患者性别、年龄、身高、体重、体质指数(BMI)、手术侧别、术前髋-膝-踝(HKA)角、术前HKA角差值、Keblish分级和Ranawat分型的差异均无统计学意义(均P>0.05)。在准确度方面,PAD组HKA角(2.0°±1.4°比3.0°±2.2°,P=0.082)、冠状面股骨组件角(CFCA)(1.5°±1.2°比2.1°±1.6°,P=0.144)和冠状面胫骨组件角(CTCA)(1.2°±0.8°比1.3°±1.0°,P=0.695)偏差值与CI组差异均无统计学意义;但PAD组HKA角、CFCA和CTCA偏差值标准差更小。在力线偏移率方面,PAD组术后HKA角内外翻超过3°的偏移率低于CI组,差异有统计学意义(P<0.05),CFCA和CTCA内外翻超过3°的偏移率亦低于CI组,但差异无统计学意义(均P>0.05)。结论在膝外翻畸形患者中,PAD辅助TKA可获得良好的下肢力线和假体位置,且在下肢整体力线的精确度和偏移率方面优于传统器械。
Objective To explore the differences of alignment and position of prosthesis between portable accelerometer-based navigation device(PAD)and conventional instrumentation(CI)in total knee arthroplasty(TKA)with valgus deformity.Methods Patients with knee osteoarthritis and valgus deformity who underwent primary TKA in Peking University Third Hospital from January 2017 to December 2020 were enrolled in this retrospective study and were divided into PAD group and CI group according to the surgical instruments.Five male patients and 44 female patients were included with a mean age of(67.2±7.0)years.The differences in preoperative general data,preoperative and postoperative alignment between the two groups were studied.Results A total of 49 patients(25 patients in the PAD group and 24 in the CI group)were enrolled in this study.There were no statistically significant differences in gender,age,height,weight,body mass index,surgical side,preoperative hip-knee-ankle(HKA)angle,preoperative HKA angle deviation,Keblish classification and Ranawat classification between the two groups(all P>0.05).There was no significant difference in the accuracy of postoperative HKA angle(2.0°±1.4°vs 3.0°±2.2°,P=0.082),coronal femoral component angle(CFCA)(1.5°±1.2°vs 2.1°±1.6°,P=0.144)and coronal tibial component angle(CTCA)(1.2°±0.8°vs 1.3°±1.0°,P=0.695)between the two groups;but the standard deviation of the above-mentioned three indices in PAD group were all smaller than those in CI group.The rate of outliers of postoperative HKA angle of the PAD group was smaller than that in the CI group(P<0.05),but there was no significant difference in the rate of outliers of CFCA and CTCA between the two groups(both P>0.05).Conclusion TKA assisted by PAD can provide good alignment and prosthesis position in patients with valgus deformity,and it is superior to TKA with CI in terms of precision and rate of outliers of postoperative overall alignment of lower extremity.
作者
王鑫光
何宜蓁
吴天晨
李杨
李子剑
田华
Wang Xinguang;He Yizhen;Wu Tianchen;Li Yang;Li Zijian;Tian Hua(Department of Orthopaedics,Peking University Third Hospital,Engineering Research Center of Bone and Joint Precision Medicine,Ministry of Education,Beijing 100191,China;School of Public Health,Peking University,Beijing 100191,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2022年第1期56-61,共6页
National Medical Journal of China
关键词
关节成形术
置换
膝
便携式导航
膝外翻
传统器械
力线对准
队列研究
Arthroplasty,replacement,knee
Portable accelerometer-based navigation
Valgus deformity
Conventional instrumentation
Alignment
Cohort study
