摘要
目的:评估计算机辅助制作个体化截骨导板(patient specific instrumentation,PSI)在膝单髁关节置换中应用的近期临床疗效。方法:回顾性分析2022年1月至2022年11月应用计算机辅助制作PSI导板行膝单髁关节置换术治疗的22例膝骨关节炎患者,男1例,女21例,年龄59.8~76.5(68.1±6.3)岁。统计手术时间、术中失血量、切口长度、垫片厚度、术后并发症,测量术后股骨假体内外翻角(femoral component varus and valgus angle,FVVA)、股骨假体屈伸角(femoral component flexion and extension angle,FFEA)、胫骨平台内外翻角(tibial component varus and valgus angle,TVVA)、胫骨假体后倾角(tibial component posterior slope angle,TPSA)、股胫机械轴夹角(hip-knee-ankle mechanical angle,HKAA)和术前及术后1、3个月美国特种外科医院(Hospital for Special Surgery,HSS)膝关节评分、美国膝关节学会评分(Knee Society score,KSS)评分。结果:所有患者获得3个月随访。手术时间(65.18±6.05)min,失血量(9.32±5.44)g·L^(-1),切口长度(10.34±0.84)cm,垫片厚度(3.55±0.86)mm。术后3个月FVVA、FFEA、TVVA、TPSA、HKAA分别为(1.20±3.69)°、(8.17±2.13)°、(2.86±1.86)°、(2.89±1.18)°、(183.15±1.46)°。术前HSS评分(64.00±2.78)分,KSS临床评分(59.09±6.16)分,KSS功能评分(47.13±5.01)分;术后1个月HSS评分(74.91±3.57)分,KSS临床评分(73.91±4.72)分,KSS功能评分(65.46±6.38)分;术后3个月HSS评分(85.00±3.25)分,KSS临床评分(83.00±2.88)分,功能评分(76.73±5.10)分;术前与术后1、3个月HSS、KSS评分比较,差异均有统计学意义(P<0.05)。结论:应用计算机辅助制作PSI截骨导板行膝单髁置换术治疗膝骨关节炎,近期临床疗效满意。此技术可以简化手术操作,使截骨和假体安放位置精准化,有助于缩短学习曲线。
Objective To evaluate the early efficacy of computer-assisted production of patient specific instrumentation(PSI)osteotomy plate in unicompartmental knee arthroplasty.Methods A retrospective analysis was conducted on 22 patients with knee osteoarthritis who underwent unicompartmental knee arthroplasty using computer-assisted production of PSI osteotomy plate between January 2022 and November 2022.The study included 1 male and 21 females,ranged from 59.8 to 76.5 years old with an average of(68.1±6.3)years old.Surgical time,intraoperative blood loss,incision length,spacer thickness,postoperative complications,postoperative femoral component varus and valgus angle(FVVA),femoral component flexion and extension angle(FFEA),tibial component varus and valgus angle(TVVA),tibial component posterior slope angle(TPSA),hip-knee-ankle mechanical angle(HKAA),and preoperative and postoperative 1-month,3-month Hospital for Special Surgery knee-rating(HSS)and American Knee Society Score(KSS)were measured.Results The surgical time was(65.18±6.05)minutes,blood loss was(9.32±5.44)g·L^(-1),incision length was(10.34±0.84)cm,and spacer thickness was(3.55±0.86)mm.The FVVA was(1.20±3.69)°,FFEA was(8.17±2.13)°,TVVA was(2.86±1.86)°,TPSA was(2.89±1.18)°,and HKAA was(183.15±1.46)°.The preoperative HSS score was(64.00±2.78)points,and KSS score was(Knee:59.09±6.16;Function:47.13±5.01).The postoperative 1-month HSS score was(74.91±3.57)points,and KSS score was(Knee:73.91±4.72;Function:65.46±6.38).The postoperative 3-month HSS score was(85.00±3.25)points,and KSS score was(Knee:83.00±2.88;Function:76.73±5.10).The comparison of preoperative and postoperative 1-month and 3-month HSS and KSS scores showed a statistically significant difference(P<0.05).Conclusion The early clinical efficacy of computer-assisted production of PSI osteotomy plate in unicompartmental knee arthroplasty for the treatment of knee osteoarthritis is satisfactory.This technique can simplify surgical procedures,improve the accuracy of osteotomy and implant placement,and help shorten the learning curve.
作者
邓煜
白新文
赵智
DENG Yu;BAI Xin-wen;ZHAO Zhi(Chongqing Orthopaedics Hospital of Traditional Chinese Medicine,Chongqing 400012,China)
出处
《中国骨伤》
2025年第7期687-692,共6页
China Journal of Orthopaedics and Traumatology
基金
重庆市科卫联合医学科研项目(编号:2022MSXM080)。
关键词
计算机辅助
个性化截骨导板
单髁置换术
膝骨关节炎
Computer-assisted
Patient specific instrumentation osteotomy plate
Unicompartmental knee arthroplasty
Knee osteoarthritis
