METHODS: Patients over 65 years, with BMI ≤ 37.5 kg/m2 and no previous joint replacements were recruited to have computer-navigated total knee arthroplasty using an APT. The study cohort (n = 27) had mean age of 71.9 (SD 4.35) and BMI of 31.2 (SD 3.8). The BMD examinations were performed 6 weeks and 18 months post-operatively. Six regions of interest (ROI) were identified on anterior/posterior and lateral dual-energy X-ray absorptiometry scans. For each ROI, BMD relative differences (RDs) were determined between limbs and RDs at the two time points were compared.
RESULTS: No differences were found between the RDs for any ROI. No revisions or complications were reported. At 18 months post-operatively, 79.2% of the cohort were very satisfied or satisfied with the outcome of their surgery and Oxford Knee Scores improved significantly compared to pre-operatively (p < 0.001). Mean knee range of motion was 102° (SD 10.7°), and mean leg alignment was 2.0° valgus (1-6°valgus).
CONCLUSIONS: Results from BMD analysis suggest that implants were well fixated without compromising function. We believe that using APTs with computer navigation is a viable cheaper option to MBTs for patients who are less active, have lower BMI and good bone quality.
方法:65岁以上的患者,BMI≤37.5kg/m2,且之前未进行关节置换,使用APT进行计算机导航全膝关节置换术.研究队列(n=27)的平均年龄为71.9(SD4.35),BMI为31.2(SD3.8)。术后6周和18个月进行BMD检查。在前/后和外侧双能量X射线吸收测量扫描中确定了六个感兴趣区域(ROI)。对于每个ROI,确定了肢体之间的BMD相对差异(RD),并比较了两个时间点的RD。
结果:没有发现任何ROI的RD之间的差异。未报告修订或并发症。术后18个月,79.2%的队列对他们的手术结果非常满意或满意,牛津膝关节评分与术前相比显着改善(p<0.001)。平均膝关节运动范围为102°(SD10.7°),平均腿部对齐为2.0°外翻(1-6°外翻)。
结论:BMD分析结果表明,植入物固定良好,不影响功能。我们认为,对于不那么活跃的患者,使用APT和计算机导航是MBT的一个可行的更便宜的选择,具有较低的BMI和良好的骨骼质量。