电脑导航系统应用于全人工膝关节置换手术之相关研究 - PLOS.DOCVIP

電腦導航人工膝關節置換與傳統人工膝關節置換之前瞻性臨床及細胞動素之追蹤與比較研究 人工膝關節置換術( TKA)是最成功之骨科手術.但傳統人工膝關節置換除了角度無法完善精準之外，因術中對股骨骨髓腔之破壞(須做femoral intramedullary rodding以作為手術之依據)，可能會有肺栓塞、腦中風，甚至心肌梗塞之虞. 電腦導航人工膝關節置換術提供精確的人工關節置入角度及量化的膝部動態，理論上會比傳統人工膝關節置換有更好的預後及一貫性的結果.電腦導航之應用,髓內器具對髓之侵犯及軟組織之破壞, 有微創手術之.可以減少手術血流動力學之穩定以及減少各系統之併發症, 包括腦部,心血管系統, 肺部系統以及腸胃系統、感染以及骨折之可能. 預期成果： 我們預期電腦導航人工膝關節置換可減低手術併發症之發生及改善手術之結果occasional outliner from perfect alignment after prosthesis implantation and unavoidable complications are still concerns. The usage of navigation-assisted system on total knee arthroplasty has provided better accuracy of the component alignment and quantity in knee kinematics, which theoretically affords better and consistent functional outcome. In addition to better alignment, the design of navigation system avoids violation of the medullary canal. This less invasive environment might be contributable to the less blood loss in the drainage bottle, less blood transfusion more stable hemodynamic status, fewer hospitalization days, and fewer complications. Systemic emboli phenomena during preparation of the femur and tibia are well recognized during total knee arthroplasty. They are widely believed to be the cause of intraoperative hypotension and reduced cardiac output, which may lead to circulatory collapse, change of mental status or cerebral infarction. Kalairajah et al reported that navigation-assisted total knee arthroplasty, when compared with conventional jig-based surgery, significantly reduces systemic emboli as detected by transcranial Doppler ultrasonography. Church et al undertook a prospective, double-blind, randomized study to compare the cardiac emboli load by tranesophageal echocardiography and demonstrated that computer-assisted TKA resulted in the release of significant fewer systemic emboli than the conventional procedure using intramedullary alignment. The increased blood loss in conventional TKA may be due to intramedullary jigging of both femur and tibia, bleeding from sinusoids