[1]谢川江,邱洪九,李帅峰,等.计算机导航辅助下间隙平衡技术在全膝关节置换术中的应用价值[J].第三军医大学学报,2019,41(21):2120-2126.
 XIE Chuanjiang,QIU Hongjiu,LI Shuaifeng,et al.Clinical value of gap balance technique guided by computer-assisted navigation in total knee replacement: report of 63 cases[J].J Third Mil Med Univ,2019,41(21):2120-2126.
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计算机导航辅助下间隙平衡技术在全膝关节置换术中的应用价值(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第21期
页码:
2120-2126
栏目:
临床医学
出版日期:
2019-11-15

文章信息/Info

Title:
Clinical value of gap balance technique guided by computer-assisted navigation in total knee replacement: report of 63 cases
作者:
谢川江邱洪九李帅峰石岭朱纪峰王子明熊雁
400042 重庆,陆军军医大学(第三军医大学)大坪医院骨科
Author(s):
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

关键词:
全膝关节置换术膝关节骨性关节炎计算机导航系统间隙平衡技术测量截骨技术
Keywords:
total knee replacement knee osteoarthritis computer navigation system gap balance technology measurement of osteotomy  
分类号:
R182.32; R319; 687.4
文献标志码:
A
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。

Abstract:

ObjectiveTo investigate the value of gap balance technique guided by computer-assisted navigation in total knee replacement. MethodsA 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. ResultsThe 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. ConclusionGap 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.

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更新日期/Last Update: 2019-11-12