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Do spacer blocks accurately estimate deformity correction and gap balance in total knee arthroplasty? A prospective study with computer navigation.

间隔块是否准确估计全膝关节置换术中的畸形矫正和间隙平衡?计算机导航的前瞻性研究。

  • 影响因子:0
  • DOI:10.1016/j.knee.2019.09.006
  • 作者列表:"Jhurani A","Agarwal P","Aswal M","Meena I","Srivastava M","Sheth NP
  • 发表时间:2020-01-01
Abstract

BACKGROUND:Spacer blocks are used commonly in knee arthroplasty to estimate gaps and ligament balance. Their use continues along with modern technology despite dearth of literature regarding their accuracy and reliability. This prospective study aims to determine the difference in values of gap and balance measurements between spacers and trials in computer assisted TKA. METHODS:50 patients with moderate varus deformity of <20° undergoing primary TKA were recruited for this prospective study. After navigation assisted cuts and requisite ligament release, gaps and balance were recorded in extension and 90° flexion with spacer block followed by implant trials. RESULTS:There were 33 females and 17 males with average BMI of 28.2 ± 5kg/m2. The average preoperative flexion deformity was 6.5° ± 4.4° and varus deformity was 8.2° ± 3.8°. Average difference of deformity in sagittal plane in extension between spacer and trial was 6.2° which was statistically significant (p = 0.001) implying that knee achieves more extension with spacer blocks as compared to trials because the blocks do not have posterior offset of the condyles. However, there was no difference between values of soft tissue balance and coronal plane correction between spacer blocks and trials in extension and 90° flexion (p > 0.05). CONCLUSION:Spacer blocks do not estimate extension space accurately with knee achieving 6.2 more flexion with trials as compared to spacer blocks when assessed for sagittal plane correction in extension. Spacer blocks should pass in easily in extension to avoid any flexion deformity when the actual trials are inserted.

摘要

背景: 膝关节置换术中常用间隔块来估计间隙和韧带平衡。尽管缺乏关于其准确性和可靠性的文献,但它们的使用仍与现代技术一起继续。本前瞻性研究旨在确定计算机辅助TKA中间隔物和试验之间的间隙和平衡测量值的差异。 方法: 50 例中度内翻畸形 <20 ° 的患者接受初次TKA。导航辅助切断和必要的韧带松解后,用间隔块记录伸展和 90 ° 屈曲时的间隙和平衡,然后进行植入物试验。 结果: 女性 33 例,男性 17 例,平均BMI为 28.2 ± 5千克kg/m2。术前平均屈曲畸形 6.5 ° ± 4.4 °,内翻畸形 8.2 ° ± 3.8 °。垫片与试验矢状面延伸畸形平均差异 6.2 °,有统计学意义 (p = 0.001)。意味着与试验相比,膝关节用间隔块获得更多的伸展,因为间隔块没有髁突的后偏移。然而,在伸展和 90 ° 屈曲方面,间隔块和试验之间的软组织平衡和冠状面矫正值没有差异 (p> 0.05)。 结论: 当评估伸展的矢状面矫正时,与间隔块相比,试验的膝关节屈曲度增加 6.2,间隔块不能准确估计伸展空间。在插入实际试验时,间隔块应易于伸展通过,以避免任何屈曲畸形。

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