본문 바로가기
KERD
논문KCI 등재

The Accuracy of Alignment Determined by Patient-Specific Instrumentation System in Total Knee Arthroplasty

2

조회

0

다운로드

3

인용

0

참고문헌

키워드

초록

Purpose: The aim of this study is to assess the accuracy of alignment determined by patient­specific instrumentation system in total knee arthroplasty (TKA).Materials and Methods: Twenty­seven TKAs using patient­specific instrument were reviewed. The intraoperative pin location determined by the patient­specific guide was recorded using imageless navigation software. Data recorded included tibial coronal alignment and posterior slope, femoral coronal alignment and sagittal alignment, and transepicondylar axis. A discrepancy within ±3° in each plane was considered an acceptable result. Results: On the tibia, an acceptable alignment was obtained in 24 (88.1%) in the coronal plane and 21 (77.8%) in the sagittal plane. On the femur, a satisfactory alignment was obtained in 25 (92.6%) in the coronal plane and 24 (88.1%) in the sagittal plane. Based on the transepicondylar axis, a satisfactory alignment was obtained in 23 (85.1%).Conclusions: Satisfactory alignment was obtained in more than 85% of each plane of the femur and in the coronal plane of the tibia and relative to the transepicondylar axis. Sufficeint experience and precise preoperative planning are required to improve the accuracy of sagittal alignment of the tibia.

Abstract

Purpose: The aim of this study is to assess the accuracy of alignment determined by patient­specific instrumentation system in total knee arthroplasty (TKA).Materials and Methods: Twenty­seven TKAs using patient­specific instrument were reviewed. The intraoperative pin location determined by the patient­specific guide was recorded using imageless navigation software. Data recorded included tibial coronal alignment and posterior slope, femoral coronal alignment and sagittal alignment, and transepicondylar axis. A discrepancy within ±3° in each plane was considered an acceptable result. Results: On the tibia, an acceptable alignment was obtained in 24 (88.1%) in the coronal plane and 21 (77.8%) in the sagittal plane. On the femur, a satisfactory alignment was obtained in 25 (92.6%) in the coronal plane and 24 (88.1%) in the sagittal plane. Based on the transepicondylar axis, a satisfactory alignment was obtained in 23 (85.1%).Conclusions: Satisfactory alignment was obtained in more than 85% of each plane of the femur and in the coronal plane of the tibia and relative to the transepicondylar axis. Sufficeint experience and precise preoperative planning are required to improve the accuracy of sagittal alignment of the tibia.

참고문헌 (20)

  1. Howell SM, "Results of an initial experience with custom-fit positioning total knee arthroplasty in a series of 48 patients", Orthopedics, 31, pp.857~863 (2008)
  2. Ng VY, "Improved accuracy of alignment with patient-specific positioning guides compared with manual instrumentation in TKA", Clin Orthop Relat Res, 470, pp.99~107 (2012)
  3. Steimle JA, "Acute perioperative comparison of patient-specific instrumentation versus conventional instrumentation utilization during bilateral total knee arthroplasty", Surg Res Pract, 2018, pp.9326459~ (2018)
  4. Stolarczyk A, "Does patient-specific instrumentation improve femoral and tibial component alignment in total knee arthroplasty? A prospective randomized study", Adv Exp Med Biol, 1096, pp.11~17 (2018)
  5. Berger RA, "Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis", Clin Orthop Relat Res, (286), pp.40~47 (1993)
  6. 김광균, "대퇴골의 기계적 축을 이용한 원위 대퇴부의 회전 정렬: 생체내 3차원 전산화 단층 촬영을 이용한 측정", 대한정형외과학회지, 46(6), pp.484~491 (2011), 대한정형외과학회
  7. Cheng T, "Does computer-assisted surgery improve postoperative leg alignment and implant positioning following total knee arthroplasty? A metaanalysis of randomized controlled trials?", Knee Surg Sports Traumatol Arthrosc, 20, pp.1307~1322 (2012)
  8. Kamat YD, "Does computer navigation in total knee arthroplasty improve patient outcome at midterm followup?", Int Orthop, 33, pp.1567~1570 (2009)
  9. Chang-Wan Kim, "Effects of Femoral Lateral Bowing on Coronal Alignment and Component Position after Total Knee Arthroplasty: A Comparison of Conventional and Navigation­-Assisted Surgery", Knee Surgery and Related Research, 30(1), pp.64~73 (2018), 대한슬관절학회
  10. Pfitzner T, "Femur positioning in navigated total knee arthroplasty", Orthopedics, 35(10 Suppl), pp.45~49 (2012)
  11. Nam D, "Patient-specific instrumentation in total knee arthroplasty : a review", J Knee Surg, 25, pp.213~219 (2012)
  12. Cenni F, "Three-dimensional implant position and orientation after total knee replacement performed with patient-specific instrumentation systems", J Orthop Res, 32, pp.331~337 (2014)
  13. Ensini A, "Intra-and post-operative accuracy assessments of two different patient-specific instrumentation systems for total knee replacement", Knee Surg Sports Traumatol Arthrosc, 22, pp.621~629 (2014)
  14. Krackow KA, "A new technique for determining proper mechanical axis alignment during total knee arthroplasty : progress toward computer-assisted TKA", Orthopedics, 22, pp.698~702 (1999)
  15. Lopomo N, "Evaluation of formal methods in hip joint center assessment : an in vitro analysis", Clin Biomech(Bristol, Avon), 25, pp.206~212 (2010)
  16. Brin YS, "Precise landmarking in computer assisted total knee arthroplasty is critical to final alignment", J Orthop Res, 28, pp.1355~1359 (2010)
  17. Siston RA, "The variability of femoral rotational alignment in total knee arthroplasty", J Bone Joint Surg Am, 87, pp.2276~2280 (2005)
  18. Zhang XL, "Rotational alignment in total knee arthroplasty : nonimage-based navigation system versus conventional technique", Chin Med J(Engl), 125, pp.236~243 (2012)
  19. Griffin FM, "Anatomy of the epicondyles of the distal femur : MRI analysis of normal knees", J Arthroplasty, 15, pp.354~359 (2000)
  20. Chan WP, "Osteoarthritis of the knee : comparison of radiography, CT, and MR imaging to assess extent and severity", AJR Am J Roentgenol, 157, pp.799~806 (1991)

관련 논문AI추천

Comparison of an Accelerometer-Based Portable Navigation System, Patient-Specific Instrumentation, and Conventional Instrumentation for Femoral Alignment in Total Knee ArthroplastyJunya Higuchi, Kazuhiko Michishita, Kohei Kawaguchi, Takeshi Manabe, Yoshiyuki Akasaka대한슬관절학회 · Knee Surgery and Related Research2017 · 제29권 제4호Kinematically Aligned Total Knee Arthroplasty with Patient-Specific Instrument김광균, 원예연, Stephen M. Howell연세대학교의과대학 · Yonsei Medical Journal2020 · 제61권 제3호Comparison of Precision between Optical and Electromagnetic Navigation Systems in Total Knee Arthroplasty박시환, 서정탁, 이승준, 조희명대한슬관절학회 · Knee Surgery and Related Research2014 · 제26권 제4호Reliability and Validity of the Femorotibial Mechanical Axis Angle in Primary Total Knee Arthroplasty: Navigation versus Weight Bearing or Supine Whole Leg Radiographs박용범, 이한준, Jung­Won Lim, Min­Ku Song, Seong Hwan Kim대한슬관절학회 · Knee Surgery and Related Research2018 · 제30권 제4호Effects of Femoral Lateral Bowing on Coronal Alignment and Component Position after Total Knee Arthroplasty: A Comparison of Conventional and Navigation­-Assisted Surgery이창락, Chang-Wan Kim대한슬관절학회 · Knee Surgery and Related Research2018 · 제30권 제1호Comparison of post-operative three-dimensional and two-dimensional evaluation of component position for total knee arthroplastyHijikata Hiroki, Kawashima Hiroyuki, Mochizuki Tomoharu, Sato Takashi, Tanifuji Osamu, Watanabe Satoshi, Yamagiwa Hiroshi대한슬관절학회 · Knee Surgery and Related Research2021 · 제33권

이 간행물의 다른 논문 (24건)