摘要
目的研究膝骨关节炎患者智能辅助手术导航系统(iASSIST)辅助人工全膝关节置换(TKA)术治疗后膝关节功能、膝关节活动度及步态参数的改善情况。方法回顾性选取石家庄市第三医院2020年5月至2022年5月收治的90例保守治疗无效、符合TKA术适应证的膝关节骨关节炎患者,排除肝肾功能异常、关节置换史及不能耐受手术者等。采用随机数字表法分为观察组和对照组,每组45例,观察组患者采取iASSIST导航系统进行治疗,对照组患者采取常规手术治疗。采用独立样本t检验分析两组患者的围手术期指标、膝关节功能恢复、关节活动情况以及步态之间的差异。结果观察组患者的手术时间、术中引流量显著高于对照组,住院时间短于对照组(t=34.957、21.372,均为P<0.05)。治疗后,两组患者的西安大略与麦克马斯特大学(WOMAC)骨关节炎评分均显著下降,且观察组治疗后1、2、3、4周患者的WOMAC评分显著低于对照组(F=19.934,P<0.05)。两组患者的髋关节最大后伸角度、支撑相膝关节最大伸膝角度、膝关节最大屈曲角度均有改善,且观察组患者改善角度高于对照组(t=26.199、5.421、21.449,均为P<0.05)。两组患者的步长不对称性、单腿支撑时间不对称性显著下降;且观察组患者的数据低于对照组(t=27.000、10.138,均为P<0.05)。结论膝骨关节炎患者iASSIST-TKA术治疗后,患者的膝关节功能、膝关节活动度以及步态得到显著提升,建议临床推广。
Objective To investigate the improvement of knee function,knee range of motion and gait parameters in patients with knee osteoarthritis after intelligent assisted surgical navigation system(iASSIST)-total knee arthroplasty(TKA).Methods Ninety patients with knee osteoarthritis in the Third Hospital of Shijiazhuang City from May 2020 to May 2022 who did not respond to conservative treatment and met the indications for TKA surgery,were selected.Those who were with abnormal renal-hepatic functions,joint replacement history and couldnot tolerate surgery were excluded.The patients were randomly divided into an observation group and a control group,with 45 cases in each group.The observation group underwent treatment using the iASSIST navigation system,while the control group received conventional surgical treatment.Independent sample t test were performed to analyze differences between the two groups in perioperative indicators,recovery of knee function,joint mobility,and gait.Results The operation time and intraoperative drainage volume of the observation group were significantly higher than those of the control group,and the length of hospital stay was shorter than that of the control group(t=34.957,21.372,both P<0.05).After treatment,the Western Ontario and McMaster Universities(WOMAC)osteoarthritis scores of patients in the two groups significantly decreased,and WOMAC scores of patients in one,two,three,and four weeks after treatment were significantly lower than those of the control group(F=19.934,P<0.05).The maximum hip extension angle,the maximum knee extension angle at stance phase and the maximum knee flexion angle of patients in the two groups were significantly improved,and the data in observation group were significantly higher than those in control group(t=26.199,5.421,21.449,all P<0.05).The asymmetry of step length and one-leg stance time in two groups significantly decreased,and the data in the observation group were significantly lower than those in the control group(t=27.000,10.138,both P<0.05).Conclus
作者
张江礼
刘金辉
潘西庆
刘光源
范虓
Zhang Jiangli;Liu Jinhui;Pan Xiqing;Liu Guangyuan;Fan Xiao(The First Department of Customs,the Third Hospital of Shijiazhuang,Shijiazhuang 050000,China)
出处
《中华关节外科杂志（电子版）》
CAS
CSCD
2024年第3期346-351,共6页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
石家庄市科学技术研究与发展指导计划(181460613)
关键词
骨关节炎
膝
手术导航系统
关节成形术
置换
膝
Osteoarthritis
Knee
Surgical navigation systems
Arthroplasty,replacement,knee
