数字化技术在控制膝关节单髁置换股骨假体力线精确性中的应用

目的 探讨基于数字技术模拟单髁术中定位过程找出股骨侧髓内定位杆的插入点来指导单髁关节置换(uni-compartmental knee arthroplasty, UKA)股骨侧截骨的准确性。方法 2016年1月至2017年1月拟行初次单髁关节置换术的50例患者采用数字技术模拟单髁术中定位过程找出股骨侧髓内定位杆的插入点进行股骨侧定位截骨,然后进行UKA手术(数字组)。随机选取2014年2月2015年12月前使用传统截骨方法进行UKA手术的50例(对照组)做对比。测量比较两组患者术后股骨假体内外翻角(FCVA),股骨假体后倾角(FCPSA)。结果 数字组和对照组术后的股骨假体内外翻角度分别为(2.05±1.06)°和(2.62±1.36)°,股骨假体后倾角度分别为(8.62±0.73)°和(6.13±1.97)°,两组之间差异均有统计学意义(t=-2.352,P=0.021；t=8.393,P=0.000),而数字组的股骨假体内外翻角及后倾角更接近0°和10°,并且离散度小,更加精准。结论 应用数字化技术找出髓内定位杆的插入点进行定位截骨方法能提高单髁置换术股骨假体定位的准确性和临床效果。
Objective To evaluate the accuracy of preoperative planning and postoperative satisfaction of prosthesis position by applying the digital technique in uni-compartmental arthroplasty (UKA). Methods Fifty patients with unicomartmenal osteoarthritis underwent UKA using the digital technique from January 2016 to January 2017 (trial group). In this trial group, the insertion of femoral guide rod was adjusted according to the preoperative plan. Other 50 patients who underwent UKA using the conventional Oxford MP process during February 2014 to December 2015 were used as control group. The postoperative femoral component valgus/varus angle (FCVA) and femoral component posterior slope angle (FCPSA) were measured and compared between two groups. Results The postoperative FCVA were(2.05±1.06)° in the trial group and(2.62±1.36)° in the control group, respectively(t=-2.352,P=0.021). Correspondingly, the FCPSA were(8.62±0.73)° and(6.13±1.97)° respectively(t=8.393,P=0.000). The postoperative FCVA and FCPSA in the trial group were closer to 0° and 10° respectively, indicating the position of femoral prosthesis was more precise. Conclusion The preoperative precise orientation of the insertion of femoral guide rod using digital technique can improve the accuracy of femoral prosthesis position and clinical results in UKA