Experimental Study And Clinical Application Of Digital Navigation Templates For Unicompartmental Knee Arthroplasty Postgraduate: Li Xiangwei Tutor: Professor Ding Jing

ObjectiveInvestigate the accuracy of the positioning of the prosthesis of the femur and tibia in the digital navigation template assisted Oxford unicompartmental arthroplasty, evaluation of the navigation template unicompartmental arthroplasty.Methods1.Select1case of knee specimens, obtained the CT scanning data,and using Mimics software and reverse engineering software to reconstruct the knee model.According to the principle of unicompartmental arthroplasty,use the modle to design and position the femoral prosthesis entrance site and central bolt direcction, depend on those,we can obtain the real navigation templates by rapid prototyping technique.2.40cases of knee specimens were randomly divided into two groups, each group of20cases.A group of digital navigation template positioning and traditional unicompartmental arthroplasty joint using, compare to the differences in positioning, and place the prosthesis in traditional postioning method. Another group use the pure digital navigation template positioning of the osteotomy and place the prosthesis.Both of the two groups are performed with the same standard,and all specimens underwent the postoperative knee lateral X radiographic examination, through the X radiographic evaluation the location of unicompartmental knee prosthesis.3.Choose10clinical unicompartmental arthroplasty patients, and design digital navigation template assisted Oxford unicompartmental replacement in4cases, traditional methods of operation in6cases.Compare intraoperative operation time and postoperative to KSS scores, follow-up of knee function, evaluate the clinical effect. Results1. Digital navigation templates and corresponding knee specimens femoral condyle and tibia platform are in good agreement, P (prosthesis central bolt sites),Q (posterior femoral condyle osteotome holes on the site), L line (tibial platform horizontal tangent line), R line (tibial plateau vertical tangent line) and traditional positioning through the statistical data, the minimum error Omm, the maximum5mm,mean0.035mm, the standard deviation of1.559, variance2.431;2.The traditional group and the navigation group in A, B, E, F four angle comparison, traditional group mean:-3.152DEG, SD7.722; navigation group:1.338degrees, SD4.384; with independent sample t test P=0.095>0.05, no significant differences in contrast. But the two groups of A, B, E, F four angle independent samples t test contrast, A angle P=0.734>0.05, E angle P=0.349>0.05,F angle P=0.349>0.05, in contrast to no significant difference,B angle P=0.034<0.05, with significant contrast difference,show that the navigation group can obviously improve the femoral prosthesis flexion extension angle.3.Two sets of clinical cases was no significant difference in the postoperative KSS score, and the navigation group than the traditional group average savings of7.82minutes.Conclusion1Digital navigation template technology can provide a new approach to improve accuracy for unicompartmental arthroplasty.2Digital navigation template assisted unicompartmental arthroplasty is the rapid prototyping technology in unicompartmental knee replacement expansion.lt is accurate,reliable and practical.3Digital navigation template technique avoids subjectivity by doctors with naked eye locating and clinical experience, shortens the operation time and learning, suitable for junior physicians to quickly learn and master.