ASSESSMENT OF THE USE OF AN INDIVIDUAL TOOL FOR KNEE ARTHROPLASTY

Maxim Golovakha, Stanislav Bondarenko
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Abstract

Objective. On the basis of comparative radiometric analysis, before and after surgery, to assess the accuracy of the knee arthroplasty with an individual instrument. Methods. The analysis of knee arthroplasty of 26 patients operated with a special instrument was performed. Age: 50–59 years — 6, 0–69 — 12, 70–79 — 5, 80 and older — 3 patients. Men — 3, women — 18. Before the operation performed a computed tomography of the lower extremities, and after operation radiography of the lower extremities completely with the vertical positions of the feet. Patient specific instrument made according to the original method. The results of the analysis were performed by comparing X-ray parameters before and after operations: 1) position of the mechanical axis in the frontal plane on the plateau of the tibia in percent; 2) medial tibial resection angle to the mechanical axis; 3) the size of the components of the endoprosthesis (femoral, tibial and liner height). Results. Deviations in the values of the medial tibial and of the lateral femoral angles between the planned and actually obtained value was an average of 0.7 %, which can be considered a high indicator of the accuracy of the implant position. The position of the mechanical axis of the limb after the operation differed from the planned by a little more than 0.9 %. The dimensions of the endoprosthesis components and the height of the tibial insert fitted to the patients matched the planning results in 100 % of the cases, with the tibial insert height being 9 mm in all cases. The use of an individual tool made it possible to reduce the time of the operation, not to open the bone marrow canal of the thigh Conclusions. The use of the original individual tool for knee arthroplasty provided a high precision to install the components of the arthroplasty.
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评估单个工具在膝关节置换术中的应用
目标。在比较放射学分析的基础上,术前和术后,评估单个器械的膝关节置换术的准确性。方法。对26例使用专用器械进行膝关节置换术的患者进行分析。年龄:50 ~ 59岁6例,0 ~ 69岁12例,70 ~ 79岁5例,80岁以上3例。男性3人,女性18人。术前对下肢进行计算机断层扫描,术后对下肢进行影像学检查,观察足部垂直位置。根据原始方法制作的患者专用器械。对比手术前后x线参数分析结果:1)机械轴在胫骨平台额平面位置的百分比;2)胫骨内侧与机械轴的切除角;3)假体组成部分的大小(股骨、胫骨和衬里高度)。结果。胫骨内侧角和股骨外侧角在计划值和实际值之间的偏差平均为0.7%,这可以被认为是植入物位置准确性的高指标。手术后肢体机械轴的位置与计划的偏差略大于0.9%。假体构件的尺寸和胫骨内嵌体的高度与患者匹配的计划结果100%匹配,所有病例的胫骨内嵌体高度均为9mm。使用单独的工具可以减少手术时间,不需要打开大腿骨髓管。使用原始的单个工具进行膝关节置换术提供了高精度的安装关节置换术的组件。
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