| 计算机辅助制作PSI截骨导板在膝单髁置换术中应用的近期疗效评价 |
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投稿时间：2023-08-21 修订日期：2023-12-24
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
| DOI： |
| 基金项目:重庆市科卫联合医学科研项目(编号：2022MSXM080) |
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| 中文摘要:目的：评估计算机辅助制作PSI（Patient Specific Instrumentation）截骨导板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，术中出血量，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、术后 1 个月、3 个月膝关节HSS（Hospital for Special Surgery knee-rating）、KSS（Knee Society Score）评分。结果：手术时间（65.18±6.05）min，失血量（9.32±5.44）g/L，切口长度（10.34±0.84）cm，垫片厚度（3.55±0.86）mm。FVVA（1.2±3.69）度，FFEA（8.17±2.13）度，TVVA（2.86±1.86）度，TPSA（2.89±1.18）度，HKAA（183.15±1.46）度。术前 HSS 评分（64.00±2.78）分，KSS评分（临床评分：59.09±6.16分；功能评分：47.13±5.01分）；术后1 个月 HSS 评分（74.91±3.57）分，KSS评分（临床评分：73.91±4.72分；功能评分：65.46±6.38分）；术后3 个月 HSS 评分（85.00±3.25）分，KSS评分（临床评分：83.00±2.88分；功能评分：76.73±5.10分）；术前与术后1月，3月HSS、KSS比较P＜0.05，差异具有统计学意义。 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。 |
| 【关键词】计算机辅助 PSI截骨导板 单髁置换术 膝骨关节炎 |
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| Evaluation of early efficacy of computer-assisted production of patient specific instrumentation osteotomy plate in unicompartmental knee arthroplasty |
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| ABSTRACT 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 from January 2022 to November 2022. The study included 1 male and 21 females, with an age range from 59.8 to 76.5 years (mean age: 68.1±6.3 years). 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, incision length was (10.34±0.84) cm, and spacer thickness was (3.55±0.86) mm. The FVVA was (1.2±3.69) degrees, FFEA was (8.17±2.13) degrees, TVVA was (2.86±1.86) degrees, TPSA was (2.89±1.18) degrees, and HKAA was (183.15±1.46) degrees. 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 with a p value <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. |
| KEY WORDS computer-assisted patient specific instrumentation osteotomy plate unicompartmental knee arthroplasty knee osteoarthritis |
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