| IntroductionTotal knee arthroplasty is still an effective method for patients with advanced knee osteoarthritis.In the traditional total knee replacement surgery,due to the anatomical variation of the master surgeon's judgment error and the inaccurate placement of the prosthesis,the mechanical failure of the prosthesis resulted in the aseptic loosening of the patellofemoral locus of the prosthesis,the accelerated wear of the prosthesis gasket and the risk of postoperative prosthesis instability.Success depends on the precision of total knee arthroplasty,bone cutting position,precise,accurate prosthetic limb line of force balance,good clearance,surgical technique,good prosthesis design,and the protection of extensor function,such as the lower limb power line,the placement of implants,ligament tension balance is the important factors that affect the knee joint activities.At present,a large number of literatures report that the computer navigation aid system can improve the lower extremity line,while the gap balance method can improve the soft tissue balance.Therefore,the research objectives of this subject are:1.To observe the clinical efficacy of total knee arthroplasty using computer-aided navigation space balance method and conventional measurement osteotomy technique,so as to determine whether the computer-aided navigation system combined with space balance method can reduce complications and improve patients' function and satisfaction in total knee arthroplasty.2.The ligamental-tension measurement tool was used to measure the ligamental-tension during the operation of interspace balance with computer-aided navigation.Methods A total of 69 patients with primary osteoarthritis of the knee underwent total knee replacement from January 2018 to September 2018,and were divided into study group(35 patients with 43 knees under computer-assisted navigation)and control group(34patients with 43 knees under measurement osteotomy).Interstitial ligament tension was recorded in the study group using the interstitial balance method,and the operation time ofthe coronal plane mechanical axial force-line surgery in the lower extremity of the two groups was measured and compared,Visual analog scores(VAS pain scores)were recorded and compared between the two groups at the 12 th month after the 1st month and the 6th month after the surgery,and indicators such as KSS scores of knee function were recorded at the 12 th month after the 1st month and the 6th month after the surgery.Results The operation time of the study group(84.5±4.7)was longer than that of the control group(65.1 ± 2.0)(P< 0.05);The incision length of the study group(13.9 ±0.7)cm was not significantly different from that of the control group [(13.9 ±0.6)cm,P>0.05];There was no significant difference in the amount of intraoperative blood loss(44.0 ± 7.3ml)between the study group and the control group [(40.2 ±7.1ml),P>0.05];There was no significant difference in postoperative drainage volume(164±30)ml between the study group and the control group [(164±27)ml,P>0.05];The length of stay in the study group(8.60±0.55)days was not significantly different from that of the control group(8.70 ± 0.67)days,P>0.05).The mechanical axial force line of the lower extremity coronal plane(0.63±0.58)in the study group was better than that in the control group [(2.02±0.56),P<0.05;VAS scores(3.53±0.50)at 1 month after surgery in the study group were better than those in the control group(4.23±0.48),P<0.05;The KSS functional score of the knee joint in the study group(69.4±5.1)one month after the operation showed a better trend than that of the control group(67.3 ± 3.8),but the difference was not statistically significant(P>0.05);There was no significant difference in KSS score and VAS score of knee function between the two groups at the 6th and 12 th months after surgery(P>0.05).In the study group,ligaments tension of 35 patients in the medial and lateral flexion and extension space ranged from 70 N to 95 N,with an average of 84 N.Conclusion In total knee replacement surgery,the computer-assisted navigation gap balance method can provide better lower limb strength lines and more accurate osteotomy than the traditional measurement osteotomy technique,which improves the accuracy of total knee replacement surgery,but increases the operation time.The patients in the computer-aided navigation gap balance group had better short-term postoperative pain recovery effect,but there was no significant difference in postoperative knee functional score between the two groups,and the long-term clinical effect still needed more follow-up studies... |
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