摘要
学术背景:计算机辅助外科手术技术已经应用于矫形和创伤外科的诸多领域。近年来,多种计算机导航系统已经被开发用于关节镜下的前交叉韧带重建手术。目的:探讨几种常用的计算机导航手术系统,在改善前交叉韧带重建结果的作用。检索策略:由该论文的研究人员检索PubMed数据库1998-09/2007-09的与导航下前交叉韧带重建相关文献,检索词"navigation,anterior cuciate ligament,reconstruction",并限定文章语言种类为English。同时,检索计算机辅助骨科手术的有关出版物。共检索到47篇文献,对资料进行初审,纳入标准:①计算机辅助关节镜下前交叉韧带重建手术技术密切相关。②同一领域选择近期发表或在权威杂志上发表的文章。排除标准:重复性研究。文献评价:文献的来源主要是关于计算机辅助关节镜下前交叉韧带重建技术和相关手术系统的应用研究。所选用的38篇文献中,8篇为综述或会议文章,其余30篇均为临床或基础实验研究。资料综合:①尽管现有的关节镜下前交叉韧带重建技术已经取得很好的疗效,但还有一些技术局限性有待改善。②计算机辅助系统特有的精确性、可靠性、安全性和可重复性在矫形和创伤的诸多领域都有应用,并取得了良好的效果。③研究表明,计算机辅助系统通过三维的可视化定位装置,提高了隧道定位的精确度;按照解剖和等距参数,避免了移植腱与股骨髁间窝切迹的撞击,实现了适合于患者个体化的前交叉韧带的准确定位植入。④与提高前交叉韧带重建临床效果有关的新观念,促进了新的计算机辅助系统的开发和改良。结论:计算机辅助手术系统可以改善手术的精确度和可靠性,满足了改善临床结果的要求。
BACKGROUND： Computer-assisted surgical technique has been introduced in many applications of orthopaedic and traumatic surgery. Recently, many computer navigation systems have been developed for arthroscopic reconstruction of the anterior cruciate ligament（ACL）. OBJECTIVE： To investigate the effects of several current computer navigation systems in arthroscopic reconstruction of the anterior cruciate ligament. RETRIEVAL STRATEGY： The relevant articles published between September 1998 and September 2007 in the English language were searched for in PubMed database by the researcher of this review with the key words ＂navigation. anterior cuciate ligament, reconstruction＂. At the same time, some were searched in computer-assisted surgery relative publications in English as well as in French. A total of 47 articles were selected and reviewed by the following standards： ①Arthrosopic reconstruction of the ACL related computer navigated surgical technique studies. ②Studies that were recently published or in high-impact journals. Exclusive criteria： repetitive studies. LITERATURE EVALUATION： The primary sources of manuscripts are arthrosopic reconstruction of the ACL related computer-assisted surgical technique application studies. Among the 38 articles selected, 8 were reviews, 30 others were clinical or elementary experimental studies. DATA SYNTHESIS： Despite the successful clinical outcomes of arthroscopy assisted ACL reconstruction, there is some room to improve for the surgical technique limitations. Computer-assisted surgical systems have been introduced in most orthopaedic and traumatic surgeries for their accuracy, reliability, security and reproducibility, and proved to achieve good results. The research indicated that the computer navigation systems can enhance the accurate placement of tunnels, regarding the anatomical and isometrical parameters, without impingement on the intercondylar notch, to achieve individual ideal implantation using three-dimensional visualization localisers. The emerging concepts for the better clinical outcome further promote the development and modification of the systems. CONCLUSION： It is possible that computer navigation systems can improve the accuracy and reliability of the various surgical procedures to improve the clinical results.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第26期5193-5200,共8页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
国家自然科学基金资助(30572428)~~
