本文選題：關(guān)節(jié)置換術(shù) + 膝　； 參考：《遵義醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:通過計算機(jī)導(dǎo)航與傳統(tǒng)技術(shù)技術(shù)的隨訪療效、股骨假體力線測量指標(biāo),比較兩種手術(shù)方法得到的療效是否存在區(qū)別,探討計算機(jī)導(dǎo)航輔助膝關(guān)節(jié)置換是否能得到更精確的股骨假體旋轉(zhuǎn)對線。方法:對2013年1月~2015年1月收治的60例膝關(guān)節(jié)骨性關(guān)節(jié)炎患者進(jìn)行前瞻性研究,隨機(jī)分成計算機(jī)導(dǎo)航組(導(dǎo)航組)和傳統(tǒng)方法組(傳統(tǒng)組),每組30例,總樣本中男16例,女44例,年齡61~82(68.3±9.8)歲;身高152.6~176.4(162.47±5.63)cm;體重49~82(64.71±7.85)kg;體重指數(shù)BMI 18~29.5(23.26±2.43)kg/m2,使用同種產(chǎn)品的關(guān)節(jié)假體,比較兩組患者股骨旋轉(zhuǎn)角度,并結(jié)合術(shù)前及術(shù)后的KSS評分、WOMAC評分、Oxford評分、膝關(guān)節(jié)活動范圍,對比兩對照組的術(shù)后早期療效。結(jié)果:隨訪時間24個月,在術(shù)前、術(shù)后1月、6月、12月、24月進(jìn)行隨訪,隨訪結(jié)果的導(dǎo)航組KSS評分、WOMAC評分、Oxford評分與傳統(tǒng)組相近,無統(tǒng)計學(xué)差異(P0.05),術(shù)后導(dǎo)航組髁扭轉(zhuǎn)角(condylar twist angle,CTA):7.3°±1.8°,傳統(tǒng)組CTA:7.0°±2.7°,P值0.05,認(rèn)為兩者有可比性,APL相對于CTEA的垂線的角度(angle between the APL and CTEA,ACA)、關(guān)節(jié)活動范圍(Range of motion,ROM)的角度作統(tǒng)計學(xué)分析P值0.05,無統(tǒng)計學(xué)意義。統(tǒng)計術(shù)后兩組的CTA、ACA角度較術(shù)前偏離位置在1°范圍內(nèi)的比例分別為CTA 70%(21例)、ACA 30%(9例),非導(dǎo)航組CTA 50%(15例)、ACA 16%(5例),ACA對線上P0.05,認(rèn)為兩者有可比性,ACA對線上P0.05,無統(tǒng)計學(xué)意義。結(jié)論:對于患者術(shù)后早期膝關(guān)節(jié)功能康復(fù)、療效及評分方面較傳統(tǒng)組無明顯差異,導(dǎo)航雖然能提高假體旋轉(zhuǎn)對線上的精確度,但限于CTA及ACA的比較結(jié)果,認(rèn)為導(dǎo)航組在假體旋轉(zhuǎn)對線上后髁軸上的對線更為精確。
[Abstract]:Objective: to compare the effects of computer navigation and traditional technique, and to compare whether there are differences between the two surgical methods. To investigate whether computer navigation assisted knee arthroplasty can obtain more accurate rotation alignment of femoral prosthesis. Methods: from January 2013 to January 2015, 60 patients with knee osteoarthritis were randomly divided into computer navigation group (navigation group) and traditional method group (30 cases in each group). 44 females, aged 68.3 鹵9.8yrs, 152.6f176.4cm. 162.47 鹵5.63cm tall, 492.82kgs 64.71 鹵7.85kg. body mass index (BMI 1829.5m2.26 鹵2.43kg / m2), the femur rotation angle was compared between the two groups, and the KSS scores before and after operation were used to evaluate the range of motion of the knee, and to compare the angle of femur rotation between the two groups, and to compare the angle of femur rotation between the two groups using the same product, combining with the KSS scores before and after the operation, and the range of motion of the knee joint. The early postoperative effects of the two control groups were compared. Results: the follow up time was 24 months. The KSS scores of navigation group were similar to those of the traditional group before, 1 month, 6 months, 12 months and 24 months after operation. There was no statistical difference (P 0.05). The angle of condylar twist angle of condylar torsion was 7.3 擄鹵1.8 擄in the navigation group, and the CTA:7.0 擄鹵2.7 擄(P = 0.05) in the traditional group. It was considered that the angle of condylar twist angle to the perpendicular line of CTEA was comparable between the two groups, and the angle of joint movement range of motion ROM was analyzed statistically (P 0.05, no statistical significance. In the two groups, the ratio of angle deviation of CTA to preoperative deviation was within 1 擄. The ratio of CTA was 70 cases (21 cases) and ACA300 (9 cases), respectively. In the non-navigation group, there were 15 cases of ACA16D and 5 cases of ACA-ACA (P0.05). The results showed that there was no significant difference between the two groups (P0.05), and there was no statistical significance between the two groups. Conclusion: there is no significant difference in curative effect and score between the early postoperative knee joint rehabilitation group and the traditional group. Although navigation can improve the accuracy of rotation on the line of prosthesis, it is limited to the results of CTA and ACA. It is considered that the alignment of the navigation group on the supracondylar axis of the prosthesis rotation is more accurate.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4

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