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山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (6): 75-81.doi: 10.6040/j.issn.1671-7554.0.2021.1467

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便携式导航与传统手术器械下的20例全膝关节置换术后早期疗效随访对比

马良,张元凯,姜淑伟   

  • 发布日期:2022-06-17
  • 通讯作者: 张元凯. E-mail:drzhangyk@163.com

Comparison of portable accelerometer-based navigation versus conventional instrumentation for total knee arthroplasty in 20 patients: the outcomes at early follow-up

MA Liang, ZHANG Yuankai, JIANG Shuwei   

  1. Department of Orthopedic Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2022-06-17

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摘要： 目的 探讨一种新型基于加速度计原理便携式导航系统下的全膝关节置换术与传统手术器械下的全膝关节置换术的手术时间、下肢力线(髋膝踝角度偏差)、股骨远端外侧角、临床效果的差异。 方法 通过随访2018年5月至2018年12月于山东大学齐鲁医院骨科行全膝关节置换术患者20例,其中男5例、女15例,56~79岁,平均(67.85±6.53)岁,根据采用手术方式不同分为导航组和传统组,每组10例,10膝,比较两组患者的术前一般资料、手术时间、术后下肢力线、股骨远端外侧角、膝关节功能评分等参数的差异。 结果 两组平均随访时间为(39.58±1.86)个月,两组患者的性别、年龄、体质量指数、术前髋膝踝角角偏差值之间,差异均无统计学意义(P>0.05)。两组在手术时间［(111.50±12.70)min vs(109.00±15.42)min,t=0.40,P=0.70］、失血量［(644.56±231.40)mL vs(604.67±250.44)mL,t=0.37 P=0.72］、股骨远端外侧角［(89.50±0.80)°vs(89.62±1.34)°,t=-0.24,P=0.81］、髋-膝-踝角度偏差［(1.96±0.93)° vs(1.83±1.03)°,t=0.28, P=0.79］、KSS评分［(94.68±3.63)vs(87.54±10.01),t=2.01, P=0.07］等方面差异无统计学意义。两组患者手术后HKA角度偏差［导航组:(9.85±4.53)° vs(1.96±0.93)°,t=5.85, P<0.001;传统组:(8.83±4.14)° vs(1.84±1.03)°, t=5.40, P<0.001］、KSS评分［导航组:(47.22±22.34)vs(94.68±3.63),t=-6.14, P<0.001;传统组(47.22±20.17)vs(87.54±10.01),t=-8.19, P<0.001］均较术前有明显改善(P<0.05)。 结论 便携式导航与传统手术相比并不能显著改善下肢力线、减少术中失血量、提高膝关节KSS评分,但便携式导航操作方便,并不显著延长手术时间。

关键词: 关节置换, 便携式导航, 膝关节骨关节炎, 传统器械, 膝

Abstract: Objective To explore the differences in operation time, mechanical axis of the lower limb, mechanical lateral distal femoral angle(mlDFA)and functional outcomes between portable accelerometer-based navigation device(PAD)and conventional instrument in total knee arthroplasty(TKA). Methods A total of 20 patients undergoing TKA at our hospital during May 2018 and Dec. 2018 were involved, including 5 males and 15 females, aged 56-79 years, mean(67.85±6.53)years. Based on the different surgical methods, they were divided into the navigation group(n=10)and conventional group(n=10). The differences in preoperative general data, operation time, deviation of hip-knee-ankle(HKA)angle, mlDFA and Knee Society Scoring System(KSS score)were compared between the two groups. Results The mean follow-up was(39.58±1.86)months. There were no significant differences in gender, age, body mass index(BMI), KSS score and preoperative deviation of HKA angle between the PAD group and conventional group(P>0.05), no significant differences in mean operation time［(111.50±12.70)min vs(109.00±15.42)min, t=0.40, P=0.70］, total blood loss［(644.56±231.40)mL vs(604.67±250.44)mL, t=0.37, P=0.72］, mlDFA［(89.50±0.80)° vs(89.62±1.34)°, t=-0.24, P=0.81］, deviation of HKA angle［(1.96±0.93)° vs(1.83±1.03)°, t=0.28, P=0.79］, and KSS score［(94.68±3.63)vs(87.54±10.01), t=2.01, P=0.07］ between the two groups. After surgery, the deviation of HKA angle［navigation group:(9.85±4.53)° vs(1.96±0.93)°, t=5.85, P<0.001; conventional group(8.83±4.14)° vs(1.84±1.03)°, t=5.40, P<0.001］ and KSS score［navigation group:(47.22±22.34)vs(94.68±3.63), t=-6.14, P<0.001; conventional group:(47.22±20.17)vs(87.54±10.01), t=-8.19, P<0.001］ were significantly improved. Conclusion There are no significant differences between the navigation group and conventional group in terms of mechanical axis, total blood loss and functional outcomes of the knee. PAD has advantage of technical simplicity without prolonging the operation time.

Key words: Arthroplasty, Portable accelerometer-based navigation device, Osteoarthritis, Conventional instrument, Knee

中图分类号: 

  • R684.3
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