基于图像的机器人辅助全膝关节置换术后滑车偏移恢复的新测量技术:可靠性研究。

IF 1.8 Q2 ORTHOPEDICS SICOT-J Pub Date : 2023-01-01 Epub Date: 2023-09-28 DOI:10.1051/sicotj/2023027
Moussa Kafelov, Jawhara Farhat, Elvire Servien, Sébastien Lustig, Cécile Batailler
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引用次数: 0

摘要

引言:全膝关节置换术(TKA)的新概念有助于改善TKA后的对齐和韧带平衡。然而,对前房的评估是困难的。本研究的目的是描述一种在初次机器人辅助TKA后CT扫描上测量滑车偏移恢复的新技术,并评估其可靠性和可重复性。方法:这项单中心研究评估了20例机器人辅助TKA后滑车偏移的CT扫描恢复情况。为了评估滑车偏移修复,我们测量了天然滑车和人工滑车之间的深度差。对滑车上的四个顺序位置进行了评估:完全伸展、30°、70°和90°屈曲。对于这些位置中的每一个,我们比较了外侧天然髁和外侧人工髁的最高点,内侧天然髁和内侧人工髁的最高点,天然滑车沟和人工滑车的最深点。两名独立评审员进行了测量,以评估其可靠性。为了确定观察者内部的变异性,第一个观察者进行了两次测量。结果:平均年龄67.3岁±8.3岁。内侧髁、滑车沟和外侧髁的滑车偏移修复平均值分别为:1.0 mm±1.6、1.1 mm±1.5、-2.7 mm±2.3-屈曲30°时为3.5 mm±1.7、-1.5 mm±1.7和-3.9 mm±3.9-屈曲70°时为5.1 mm±1.8、2.1 mm±2.7、-3.8 mm±1.8;内侧和外侧髁在90°屈曲时分别为2.0 mm±1.4和3.1 mm±1.5。放射学测量显示观察者内部和观察者之间的一致性非常好,平均kappa值分别为0.92和0.74。结论:我们提出了一种新的CT扫描测量技术,用于评估TKA后滑车偏移的恢复情况,证明了观察者之间和观察者内部的良好可靠性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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New measurement technique for restoration of the trochlear offset after image-based robotic-assisted total knee arthroplasty: a reliability study.

Introduction: The new concepts in total knee arthroplasty (TKA) tend to improve the alignment and ligament balancing after TKA. Nevertheless, the assessment of the anterior compartment is difficult. The purpose of this study was to describe a new measurement technique of trochlear offset restoration on CT-scan after primary robotic-assisted TKA and assess its reliability and repeatability.

Method: This monocentric study assessed the trochlear offset restoration on a CT scan after 20 robotic-assisted TKA. To evaluate the trochlear offset restoration, we measured the depth difference between the native and the prosthetic trochlea. Four sequential positions were assessed on the trochlea: at full extension, at 30°, 70°, and 90° flexion. For each of these positions, we compared the highest point of the lateral native condyle and the lateral prosthetic condyle, the highest point of the medial native condyle and the medial prosthetic condyle, the deepest point of the native trochlear groove and the prosthetic trochlea. Two independent reviewers performed the measurements to assess their reliability. To determine intraobserver variability, the first observer performed the measurements twice.

Results: The mean age was 67.3 years old ± 8.3. Mean values of the trochlear offset restoration for the medial condyle, trochlear groove and lateral condyle were respectively: 1.0 mm ± 1.6, 1.1 mm ± 1.5, -2.7 mm ± 2.3 in full extension; -3.5 mm ± 1.7, -1.5 mm ± 1.7, -3.9 mm ± 3.9 at 30° flexion; -5.1 mm ± 1.8, 2.1 mm ± 2.7, -3.8 mm ± 1.8 at 70° flexion; 2.0 mm ± 1.4 and 3.1 mm ± 1.5 for the medial and lateral condyles at 90° flexion. The radiographic measurements showed very good to excellent intra-observer and inter-observer agreements with mean kappa values of 0.92 and 0.74.

Conclusion: We present a novel measurement technique on CT scan for evaluating the restoration of the trochlear offset after TKA, demonstrating excellent inter and intra-observer reliability.

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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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