计算机导航全膝关节置换术在创伤后股骨干严重畸形患者中的应用

目的介绍计算机导航辅助全膝关节置换术（TKA）在伴有关节外股骨严重畸形患者中的应用.方法 回顾分析了在2005年1月至2010年为5月间,我院共收治了伴有股骨严重畸形的单侧膝关节骨性关节炎患者6例,在计算机导航辅助下进行了人工全膝关节置换术.结果平均随访27个月.术前膝评分平均10分,膝功能评分平均22分.术后膝评分平均85分,膝功能评分72分.术后下肢力线偏差均在3°以内.无患者出现导航相关并发症.结论对于伴有严重关节外畸形的患者,计算机导航全膝关节置换术不需要进行股骨、胫骨截骨,手术创伤相对较小,术后患者恢复快.对此类患者计算机导航全膝关节置换术具有良好的适应证.

Navigated total knee arthroplasty in patients with severe extra-articular femoral deformity

Objective To review our experience in computer-assisted total knee arthroplasty （TKA） for the treatment of severe extra-articular femoral deformity with ipsilateral otsteoarthritis of the knee. Methods The results of computer-assisted total knee arthroplasty in six knees with osteoarthritis and associated extra-articular deformity were reviewed retrospectively. The femoral deformity resulted from fracture malunion in all six knees and no extra-articular osteotomy was made. Results The duration of follow-up averaged twenty-seven months. According to the classification system of the Knee Society, the mean function score increased from 22 points preoperatively to 72 points at the time of last follow-up and the mean knee score increased from 10 points preoperatively to 85 points at the time of last follow-up. The mechanical alignment in the coronal plane was restored and the deviation was within three degrees of normal in each patient. No complication relating to navigation techniques happened. Conclusions For the patients with large extra-articular deformity and complex imbalance of the collateral ligaments, computer- assisted total knee arthroplasty may be a better choice, which provides no extra-articular osteotomy, less invasions and quick recovery.