个性化截骨工具辅助下人工全膝关节置换与传统人工全膝关节置换手术精确度及临床疗效比较

目的比较3D打印个性化截骨工具辅助（patient-specific instrumentation，PSI）下人工全膝关节置换术（total knee arthroplasty，TKA）与传统TKA的手术精确度和临床疗效。方法自2017年9月至2018年12月，将40例拟接受初次膝关节置换患者随机分为2组，每组均为20人。一组应用个性化截骨工具辅助TKA手术（PSI组），另一组接受传统TKA（对照组）。比较两组患者的冠状面下肢机械轴线、手术时间、术中出血量、术后引流量以及HSS评分。结果对照组和PSI组的手术时间分别为（103.3±18.7） min和（91.3±15.7） min；术中出血量分别为（372.0±53.0） mL和（332.8±47.0） mL；术后引流量分别为（378.8±97.2） mL和（315.0±89.0） mL。两组手术时间、术中出血量、术后引流量比较差异均有统计学意义（P<0.05）。对照组和PSI组术后2周HSS评分分别为（89.3±2.8）分和（88.7±2.9）分，两组比较差异无统计学意义（P>0.05）。对照组和PSI组术后全下肢力线差值分别为（1.9±1.1）°和（1.2±1.0）°，冠状面股骨假体角度（frontal femoral component angle，FFC）差值分别为（2.1±1.1）°和（1.1±0.9）°，两组比较差异有统计学意义（P<0.05）。冠状面胫骨假体角度（frontal tibia component angle，FTC）差值分别为（1.3±0.8）°和（1.4±0.8）°，两组比较差异无统计学意义（P>0.05）。结论 PSI辅助TKA较传统TKA手术时间更短、术中出血量更少，并且术后冠状面全下肢力线及股骨力线的改善优于传统TKA手术。

英文摘要:

Objective Comparing the value of the patient-specific instrument TKA to that of conventional TKA in terms of operational precision and clinical efficacy. Methods From September 2017 to December 2018, a total of 40 patients waiting for primary TKA were enrolled and randomized into two groups (each group consisted of 20 patients). One group was treated with TKA using patient-specific instrument (PSI group) and the other group was treated with conventional TKA (control group). The outcome measures were coronal mechanical alignment, time of operation，intra-operative blood loss，drainage volume and HSS score. Results Operative time in control group was (103.3±18.7) min and (91.3±15.7) min in PSI group; intra-operative blood loss in control group was(372.0±53.0) mL and (332.8±47.0) mL in PSI group; drainage volume in control group was (378.8±97.2) mL and (315.0±89.0) mL in PSI group. There were statistical differences between two groups in these three items. There was no significant difference in postoperative HSS score at 2 weeks between control group (89.3±2.8) and (88.7±2.9) in PSI group. Postoperative limb alignment deviation in control group was (1.9±1.1)°, and (1.2±1.0)°in PSI group; frontal femoral component angle (FFC) deviation in control group was (2.1±1.1)° and (1.1±0.9)° in PSI group. There were statistical differences between two groups in these two items. Frontal tibia component angle (FTC) deviation in control group was (1.3±0.8)° was similar with that in PSI group (1.4±0.8)°. Conclusion The use of PSI can contribute in achieving better limb alignment, FFA and decreased operation time, intra-operative blood loss and drainage volume.

查看全文查看/发表评论下载PDF阅读器