计算机辅助导航下的微创膝关节单髁置换

摘要

BACKGROUND: Computer navigation system in total hip replacement can strictly locate prosthetic position.OBJECTIVE: To explore the feasibility and preliminary effect of minimally invasive surgery unicompartmental knee arthroplasty(MIS-UKA) assisted by computer navigation system.METHODS: Between May 2009 and May 2010, 28 consecutive patients (28 knees) with unicompartmental knee osteoarthritiswere treated with MIS-UKA assisted by computer navigation system.RESULTS AND CONCLUSION: All cases were followed up for average 18 months (12-24 months). The mean length of incisionwas 6.8 cm, the mean surgical time was 91.6 minutes, the mean blood loss during operation was 45.8 mL and the mean drainagewas 38.5 mL. At the last follow up, all cases achieved significant relief of pain, improvement of HSS score and range of motion,and correction of varus deformity. None had complications of infection, fat embolism, deep vein thrombosis, malposition ofprosthesis, dislocation and loosing. Computer navigation system-assisted MIS-UKA gives a better correction of alignment of theleg and orientation of the components. Computer navigation system can effectively improve the outcome of MIS-UKA.%背景:人工关节置换在计算机导航手术的帮助下,可以严格把握假体位置的准确性,使其精确匹配.目的:观察计算机导航下微创膝关节单髁置换的治疗效果.方法:回顾性分析2009-05/2010-05上海市杨浦区中心医院骨科收治的内侧间室骨性关节炎患者28例(28膝)的临床资料,均应用计算机导航辅助下的微创膝关节单髁置换进行治疗.结果与结论:28例患者随访12~24个月.切口平均6.8 cm,置换中出血平均45.8 mL,平均置换时间91.6 min,置换后24 h平均引流量38.5 mL.下肢力线由置换前平均7.0°减少为置换后平均2.0°(P < 0.05).置换后膝关节活动范围平均125°,较置换前平均100°明显提高(P < 0.05).末次随访患者膝关节HSS评分平均94分,优良率94%,相比置换前评分平均78分(69~80分)有明显的改善(P < 0.05).提示计算机导航下微创膝关节单髁置换能提高术中截骨和假体植入的精确性,有效恢复下肢力线.