Restoration of the Mechanical Axis in Total Knee Artrhoplasty Using Patient-Matched Technology Cutting Blocks. A Retrospective Study of 132 Cases | ||
The Archives of Bone and Joint Surgery | ||
مقاله 3، دوره 5، شماره 5، آذر 2017، صفحه 283-289 اصل مقاله (666.81 K) | ||
نوع مقاله: RESEARCH PAPER | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2017.14182.1337 | ||
نویسندگان | ||
Dimitrios N. Lyras* 1؛ Robert Greenhow2؛ Craig Loucks2 | ||
1Minimal Invasive Hip and Knee Fellow, Sky Ridge Medical Center, 10101 Ridgegate, Lone Tree, Colorado, USA | ||
2Orthopedic and Trauma Surgeon, Sky Ridge Medical Center, 10101 Ridgegate, Lone Tree, Colorado, USA | ||
چکیده | ||
Background: The aim of this study is to evaluate the accuracy of bone cuts and the resultant alignment, using the MyKnee patient specific cutting blocks. Methods: We retrospectively reviewed 132 patients undergoing primary TKR for osteoarthritis by one single surgeon. The operative time, the preoperative Hip-Knee-Ankle (HKA) axis based on the CT-scan, the postoperative HKA axis based on long axis standing x-rays, the planned and the actual size of the femoral and the tibial components, and the number of the recuts which has been made intraoperative were measured. Results: The average preoperative HKA axis was 177.50 (range 163.50 to 1940), whereas the average postoperative HKA axis was 179.40 (range 177.10 to 182.70). No outliers were reported in the study (0%). Intraoperatively, 4 femoral components (3.03%), and 7 tibial components (5.30%) applied to the patients were different than the planned size. There was no need of recuts in any of our cases intraoperatively. Conclusion: The MyKnee system evaluated in this study was shown to be remarkable reliable in the coronal plane alignment, and the prediction of the component size. However, further studies are needed to determine whether there are any clinically important improvements in outcomes or patient satisfaction when using patient-specific cutting blocks for TKA. | ||
کلیدواژهها | ||
CT Scan؛ HKA ankle؛ Knee alignment؛ Patient specific instruments؛ Total knee arthroplasty | ||
مراجع | ||
1. Barke S, Musanhu E, Busch C, Stafford G, Field R. Patient -matched total knee arthroplasty: does it offer any clinical advantages? Acta Orthop Belg. 2013; 79(3):307-11. 2. Rodricks DJ, Patil S, Pulido P, Colwell CW Jr. Press-fit condylar design total knee arthroplasty. Fourteen to seventeen year follow-up. J Bone Joint Surg Am. 2007; 89(1):89-95. 3. Vessely MB, Whaley AL, Harmsen WS, Schleck CD, Berry DJ. The Chitranjan Ranawat Award: long term survivorship and failure modes of 1000 cemented condylar total knee arthroplasties. Clin Orthop Relat Res. 2006; 452(11):28-34. 4. Kim SJ, MacDonald M, Hernandez J, Wixson RL. Computer assisted navigation in total knee arthroplasty: improved coronal alignment. J Arthroplasty. 2005; 20(7 Suppl 3):123-31. 5. Jeffery RS, Morris RW, Denham RA. Coronal alignment after total knee replacement. J Bone Joint Surg Br. 1991; 73(5):709-14. 6. Ritter MA, Faris PM, Keating EM, Meding JB. Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop Relat Res. 1994; 299(2):153-6. 7. Hetaimish BM, Khan MM, Simunovic N, Al-Harbi HH, Bhandari M, Zalzal PK. Meta-analysis of navigation vs conventional total knee arthroplasty. J Arthroplasty. 2012; 27(6):1177-82. 8. Mason JB, Fehring TK, Estok R, Banel D, Fahrbach K. Meta-analysis of alignment outcomes in computer-assisted total knee arthroplasty surgery. J Arthroplasty. 2007; 22(8):1097-106. 9. Lustig S, Fleury C, Goy D, Neyret P, Donell ST. The accuracy of acquisition of an imageless computerassisted system and its implication for knee arthroplasty. Knee. 2011; 18(1):15-20. 10. Harvie P, Sloan K, Beaver RJ. Computer navigation vs conventional total knee arthroplasty five-year functional results of a prospective randomized trial. J Arthroplasty. 2012; 27(5):667-72. 11. Spencer JM, Chauhan SK, Sloan K, Taylor A, Beaver RJ. Computer navigation versus conventional total knee replacement: no difference in functional results at two years. J Bone Joint Surg Br. 2007; 89(4):477-80. 12. Lombardi AV Jr, Berend KR, Adams JB. Patient-specific approach in total knee arthroplasty. Orthopedics. 2008; 31(9):927-30. 13. Noble JW Jr, Moore CA, Liu N. The value of patient matched instrumentation in total knee arthroplasty. J Arthroplasty. 2012; 27(1):153-5. 14. Bathis H, Perlick L, Tingart M, Lüring C, Zurakowski D, Grifka J. Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br. 2004; 86(5):682–7. 15. Rand JA, Coventry MB. Ten-year evaluation of geometric total knee arthroplasty. Clin Orthop. 1988; 232(7):168-73. 16. Howell SM, Howell SJ, Kuznik KT, Cohen J, Hull ML. Does a kinematically aligned total knee arthroplasty restore function without failure regardless of alignment category? Clin Orthop Relat Res. 2013; 471(3):1000–7. 17. Bellemans J, Colyn W, Vandenneucker H, Victor J. The Chitranjan Ranawat award: is neutral mechanical alignment normal for all patients? The concept of constitutional varus. Clin Orthop Relat Res. 2012; 470(1):45–53. 18. Blakeney WG, Khan RJ, Wall SJ. Computer-assisted techniques versus conventional guides for component alignment in total knee arthroplasty: a randomized controlled trial. J Bone Joint Surg Am. 2011; 93(15):1377–84. 19. Brin YS, Nikolaou VS, Joseph L, Zukor DJ, Antoniou J. Imageless computer assisted versus conventional total knee replacement: a Bayesian meta-analysis of 23 comparative studies. Int Orthop. 2011; 35(3):331–9. 20. Nunley RM, Ellison BS, Ruh EL, Williams BM, Foreman K, Ford AD, et al. Are patient-specific cutting blocks cost effective for total knee arthroplasty? Clin Orthop Rel Res. 2012; 470(3):889-94. 21. Conteduca F, Iorio R, Mazza D, Caperna L, Bolle G, Argento G, et al. Are MRI-based, patient matched cutting jigs as accurate as the tibial guides? Int Orthop. 2012; 36(8):1589-93. 22. Ng VY, DeClaire JH, Berend KR, Gulick BC, Lombardi AV Jr. Improved accuracy of alignment with patientspecific positioning guides compared with manual instrumentation in TKA. Clin Orthop Relat Res. 2012; 470(1):99-107. 23. Koch PP, Müller D, Pisan M, Fucentese SF. Radiographic accuracy in TKA with a CT-based patient-specific cutting block technique. Knee Surg Sports Traumatol Arthrosc. 2013; 21(10):2200-5. 24. Anderl W, Pauzenberger L, Kölblinger R, Kiesselbach G, Brandl G, Laky B, et al. Patient-specific instrumentation improved mechanical alignment, while early clinical outcome was comparable to conventional instrumentation in TKA. Knee Surg Sports Traumatol Arthrosc. 2016; 24(1):102-11. 25. Bowers ME, Trinh N, Tung GA, Crisco JJ, Kimia BB, Fleming BC. Quantitative MR imaging using “LiveWire” to measure tibiofemoral articular cartilage thickness. Osteoarthritis Cartilage. 2008; 16(10):1167-73. 26. Koo S, Giori NJ, Gold GE, Dyrby CO, Andriacchi TP. Accuracy of 3D cartilage models generated from MR images is dependent on cartilage thickness: laser scanner based validation of in vivo cartilage. J Biomech Eng. 2009; 131(12):121004. | ||
آمار تعداد مشاهده مقاله: 1,835 تعداد دریافت فایل اصل مقاله: 1,195 |