摘要目的 比较计算机导航辅助与传统内侧开放楔形胫骨高位截骨术(open wedge high tibial osteotomy,OWHTO)治疗膝关节内侧间室骨关节炎的早期临床疗效,探讨计算机导航辅助OWHTO手术优势。方法 前瞻性研究芜湖市第一人民医院骨一科2019年6月至2021年6月60例(60膝)行OWHTO手术的膝关节内侧骨关节炎患者,根据术中是否使用计算机导航辅助分为导航组(30例30膝)和非导航组(30例30膝)。导航组男14例,女16例;年龄57~69岁,平均年龄(62.77±3.44)岁。非导航组男13例,女17例;年龄56~69岁,平均年龄(62.13±3.54)岁。比较两组患者的手术时间、术中透视次数、术后并发症、胫股角、胫骨近端内翻角、Δ胫股角(术后实际胫股角与术前设计胫股角的差值绝对值)、术后美国特种外科医院(hospital for special surgery,HSS)膝关节评分和西安大略和麦克马斯特大学(Western Ontario and McMaster Universities,WOMAC)骨关节炎指数评分等。结果 60例患者均获得1年以上随访,平均(16.68±3.42)个月。导航组手术时间(85.87±4.67) min,较非导航组(80.60±6.77) min长,差异有统计学意义(P<0.01)。导航组术中透视次数(5.00±0.95)次,较非导航组(9.80±1.13)次少,差异有统计学意义(P<0.01)。两组患者手术前后胫股角、胫骨近端内翻角比较,差异无统计学意义(P>0.05)。两组患者Δ胫股角比较,差异有统计学意义(P<0.05)。导航组术后各时间段HSS膝关节评分和WOMAC评分与非导航组比较,差异无统计学意义(P>0.05)。两组患者术后手术并发症发生率差异无统计学意义(P>0.05)。结论 计算机导航辅助OWHTO手术能提高术后下肢力线纠正的精准度,减少术中透视次数,但计算机导航相对增加手术时间。计算机导航辅助OWHTO手术近期临床效果与传统手术比较无优势,中远期疗效有待进一步研究。
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