Comparison of Postoperative Alignment of Total Knee Replacement Using Computer-Assisted Navigation with Conventional Guiding System in Chinese Population with Significant Coronal Femoral Bowing: 對比傳統全膝關節置換術和電腦導航全膝關節置換術

Background/PurposeCoronal femoral bowing is common in Chinese population. This might affect the restoration of mechanical alignment in conventional total knee replacement (TKR). The aim of the study was to compare the postoperative alignment of conventional TKR with computer-assisted navigation TKR (CAN-TKR), to investigate the effect of femoral bowing on postoperative alignment in conventional TKR and to understand the role of CAN-TKR in limbs with significant femoral bowing.MethodsThis is a retrospective study of 331 knees that underwent TKR (either conventional or CAN-TKR) in our centre from January 2010 to June 2012. The incidence of coronal femoral bowing was measured. The postoperative alignments were compared between the two groups.ResultsThe incidence of excessive coronal femoral bowing was 41.4%. For patients with or without significant coronal femoral bowing, the CAN-TKR group was significantly better in restoring postoperative mechanical axis and the coronal femoral angle (p < 0.05). Proportions of outliers were also much less in the CAN-TKR group.ConclusionCAN-TKR reduces outliers in all patients, and is especially superior in restoring mechanical alignments in patients with significant coronal femoral bowing.

中文摘要背景股骨曲彎在中國人中十分常見。這可能會影響全膝關節置換術後的效果。此硏究目的是要在 此類患者中對比傳統全膝關節置換術和電腦導航全膝關節置換術對於術後下肢角度方向的分別。方法在2010 年一月至2012 年六月期間， 331 個全膝關節置換手術（用傳統或電腦導航方式) 於本部門進行。我們計算有股骨曲彎的病人比率與及在兩種全膝關節置換手術方式中對比量度術後 下肢角度的分別。結果41.4%的中國人有股骨曲彎。對比用傳統方法，電腦導航全膝關節置換術後的病人有更佳的 術後下肢角度方向。結論電腦導航全膝關節置換術比較傳統方法，於多有股骨曲彎的中國人中有更佳的術後下肢角度 效果。