Background class='Para'>Computer-assisted total knee replacement (TKR) has been shown to improve radiographic alignment and therefore the clinical outcome. Outliers with greater '/> Is computer-assisted total knee replacement for beginners or experts? Prospective study among three groups of patients treated by surgeons with different levels of experience
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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Is computer-assisted total knee replacement for beginners or experts? Prospective study among three groups of patients treated by surgeons with different levels of experience
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Is computer-assisted total knee replacement for beginners or experts? Prospective study among three groups of patients treated by surgeons with different levels of experience

机译：是初学者还是专家使用计算机辅助全膝关节置换术？在三组具有不同经验水平的外科医生治疗的患者中进行前瞻性研究

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class="Heading">Background class="Para">Computer-assisted total knee replacement (TKR) has been shown to improve radiographic alignment and therefore the clinical outcome. Outliers with greater than 3° of varus or valgus malalignment in TKR can suffer higher failure rates. The aim of this study was to determine the impact of experience with both computer navigation and knee replacement surgery on the frequency of errors in intraoperative bone cuts and implant alignment, as well as the actual learning curve. class="Heading">Materials and methods class="Para">Three homogeneous groups who underwent computer-assisted TKR were included in the study: group A [surgery performed by a surgeon experienced in both TKR and computer-assisted surgery (CAS)], B [surgery performed by a surgeon experienced in TKR but not CAS], and C [surgery performed by a general orthopedic surgeon]. In other words, all of the surgeons had different levels of experience in TKR and CAS, and each group was treated by only one of the surgeons. Cutting errors, number of re-cuts, complications, and mean surgical times were recorded. Frontal femoral component angle, frontal tibial component angle, hip–knee–ankle angle, and component slopes were evaluated. class="Heading">Results class="Para">The number of cutting errors varied significantly: the lowest number was recorded for TKR performed by the surgeon with experience in CAS. Superior results were achieved in relation to final mechanical axis alignment by the surgeon experienced in CAS compared to the other surgeons. However, the total number of outliers showed no statistically significant difference among the three surgeons. After 11 cases, there were no differences in the number of re-cuts between groups A and C, and after 9 cases there were no differences in surgical time between groups A and B. class="Heading">Conclusion class="Para">A beginner can reproduce the results of an expert TKR surgeon by means of navigation (i.e., CAS) after a learning curve of 16 cases; this represents the break-even point after which no statistically significant difference is observed between the expert surgeon and the beginner utilizing CAS.
机译：class =“ Heading”>背景 class =“ Para”>计算机辅助全膝关节置换（TKR）已显示可改善射线照相的对准性，从而改善临床效果。 TKR内翻或外翻错位大于3°的异常值可能会导致更高的故障率。这项研究的目的是确定计算机导航和膝关节置换术的经验对术中切骨和植入物对准的错误频率以及实际学习曲线的影响。 class =“标题“>材料和方法 class =” Para“>接受了计算机辅助TKR的三个同质组：A组[由具有TKR和计算机辅助手术经验的外科医生进行的手术（CAS）]，B [由具有TKR经验的外科医生进行的手术，而不是CAS]和C [由普通骨科外科医生进行的手术]。换句话说，所有外科医生在TKR和CAS方面都有不同的经验水平，并且每个组仅由一名外科医生治疗。记录切割错误，重新切割次数，并发症和平均手术时间。评估了额部股骨成分角，额胫骨成分角，髋-膝-踝角和成分斜率。 class =“ Heading”>结果 class =“ Para”>数字切削误差的差异很大：具有CAS经验的外科医生对TKR的记录最低。与其他外科医生相比，CAS方面的外科医生在最终机械轴对准方面取得了优异的结果。但是，三位外科医生之间的异常值总数没有统计学上的显着差异。在11例之后，A组和C组之间的再切除次数没有差异，在9例之后，A组和B组之间的手术时间也没有差异。 class =“ Heading”>结论 class =“ Para”>，初学者可以在16例学习曲线后通过导航（即CAS）重现TKR专家外科医生的结果;这代表盈亏平衡点，在那之后，专家医师和使用CAS的初学者之间没有观察到统计学上的显着差异。

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