计算机导航辅助膝关节置换股骨假体旋转力线的初步研究

发布时间：2018-05-30 19:44

本文选题：关节置换术 + 膝　；参考：《遵义医学院》2017年硕士论文

【摘要】：目的:通过计算机导航与传统技术技术的随访疗效、股骨假体力线测量指标,比较两种手术方法得到的疗效是否存在区别,探讨计算机导航辅助膝关节置换是否能得到更精确的股骨假体旋转对线。方法:对2013年1月~2015年1月收治的60例膝关节骨性关节炎患者进行前瞻性研究,随机分成计算机导航组(导航组)和传统方法组(传统组),每组30例,总样本中男16例,女44例,年龄61~82(68.3±9.8)岁;身高152.6~176.4(162.47±5.63)cm;体重49~82(64.71±7.85)kg;体重指数BMI 18~29.5(23.26±2.43)kg/m2,使用同种产品的关节假体,比较两组患者股骨旋转角度,并结合术前及术后的KSS评分、WOMAC评分、Oxford评分、膝关节活动范围,对比两对照组的术后早期疗效。结果:随访时间24个月,在术前、术后1月、6月、12月、24月进行随访,随访结果的导航组KSS评分、WOMAC评分、Oxford评分与传统组相近,无统计学差异(P0.05),术后导航组髁扭转角(condylar twist angle,CTA):7.3°±1.8°,传统组CTA:7.0°±2.7°,P值0.05,认为两者有可比性,APL相对于CTEA的垂线的角度(angle between the APL and CTEA,ACA)、关节活动范围(Range of motion,ROM)的角度作统计学分析P值0.05,无统计学意义。统计术后两组的CTA、ACA角度较术前偏离位置在1°范围内的比例分别为CTA 70%(21例)、ACA 30%(9例),非导航组CTA 50%(15例)、ACA 16%(5例),ACA对线上P0.05,认为两者有可比性,ACA对线上P0.05,无统计学意义。结论:对于患者术后早期膝关节功能康复、疗效及评分方面较传统组无明显差异,导航虽然能提高假体旋转对线上的精确度,但限于CTA及ACA的比较结果,认为导航组在假体旋转对线上后髁轴上的对线更为精确。
[Abstract]:Objective: to compare the effects of computer navigation and traditional technique, and to compare whether there are differences between the two surgical methods. To investigate whether computer navigation assisted knee arthroplasty can obtain more accurate rotation alignment of femoral prosthesis. Methods: from January 2013 to January 2015, 60 patients with knee osteoarthritis were randomly divided into computer navigation group (navigation group) and traditional method group (30 cases in each group). 44 females, aged 68.3 卤9.8yrs, 152.6f176.4cm. 162.47 卤5.63cm tall, 492.82kgs 64.71 卤7.85kg. body mass index (BMI 1829.5m2.26 卤2.43kg / m2), the femur rotation angle was compared between the two groups, and the KSS scores before and after operation were used to evaluate the range of motion of the knee, and to compare the angle of femur rotation between the two groups, and to compare the angle of femur rotation between the two groups using the same product, combining with the KSS scores before and after the operation, and the range of motion of the knee joint. The early postoperative effects of the two control groups were compared. Results: the follow up time was 24 months. The KSS scores of navigation group were similar to those of the traditional group before, 1 month, 6 months, 12 months and 24 months after operation. There was no statistical difference (P 0.05). The angle of condylar twist angle of condylar torsion was 7.3 掳卤1.8 掳in the navigation group, and the CTA:7.0 掳卤2.7 掳(P = 0.05) in the traditional group. It was considered that the angle of condylar twist angle to the perpendicular line of CTEA was comparable between the two groups, and the angle of joint movement range of motion ROM was analyzed statistically (P 0.05, no statistical significance. In the two groups, the ratio of angle deviation of CTA to preoperative deviation was within 1 掳. The ratio of CTA was 70 cases (21 cases) and ACA300 (9 cases), respectively. In the non-navigation group, there were 15 cases of ACA16D and 5 cases of ACA-ACA (P0.05). The results showed that there was no significant difference between the two groups (P0.05), and there was no statistical significance between the two groups. Conclusion: there is no significant difference in curative effect and score between the early postoperative knee joint rehabilitation group and the traditional group. Although navigation can improve the accuracy of rotation on the line of prosthesis, it is limited to the results of CTA and ACA. It is considered that the alignment of the navigation group on the supracondylar axis of the prosthesis rotation is more accurate.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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