Chinese Journal of Tissue Engineering Research ›› 2014, Vol. 18 ›› Issue (53): 8553-8559.doi: 10.3969/j.issn.2095-4344.2014.53.005

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Self-made assembly osteotomy instrument for minimally invasive total knee arthroplasty: influential factors for extending incision length

Li Shuai-hua, Xu Dong-liang, He Pei-heng, Huang Shuai, Wa Qing-de, Zuo Jian-wei, Zhang Juan   

  1. Department of Joint Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
  • Revised:2014-11-25 Online:2014-12-24 Published:2014-12-24
  • Contact: Xu Dong-liang, Doctoral supervisor, Professor, Chief physician, Department of Joint Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
  • About author:Li Shuai-hua, Studying for doctorate, Attending physician, Department of Joint Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
  • Supported by:

    Sun Yat-sen University Clinical Medical Research “5010” Project, No. 2010005

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Abstract:

BACKGROUND: Commonly used minimally invasive total knee arthroplasty instruments are difficult to be operated. Accuracy of osteotomy and prosthesis installation was poor.
OBJECTIVE: To evaluate the use value of self-made assembly osteotomy instrument in minimally invasive total knee arthroplasty.
METHODS: From June 2012 to March 2014, self-made minimally invasive instrument was used to perform  8-10 cm QS minimally invasive total knee arthroplasty in 45 patients (49 knees). After osteotomy, the operative field was exposed by retractors. Prosthesis placement needed to extend the length of incision. 49 knees were assigned to < 1.0 cm extension group (n=16) and 1.0-2.0 cm extension group (n=33). The differences in factors (body mass index, lower limb length, the length of the patellar tendon, patellar thickness, longitudinal and transverse diameter, and prosthesis model) affecting extension of incision length and the healing of the incision were compared between the two groups.
RESULTS AND CONCLUSION: Operative incision of all patients was healed in stage I. No complications such as infection, deep vein thrombosis, vascular and nerve damage. Our designed minimally invasive instrument could be used in osteotomy, but the incision should be extended for prosthesis placement. The final length of the incision was (10.3±1.2) cm (9-12 cm). Significant differences in body mass index, the length of the patellar tendon, patellar thickness, longitudinal and transverse diameter, and prosthesis model were detected between < 1.0 cm extension group and 1.0-2.0 cm extension group (P < 0.05). The increase in above factors can impact the length of the incision. However, no significant difference was detectable in the lower limb length between the two groups (P > 0.05). These data indicate that self-made minimally invasive instrument is simple to be operated, can be perfectly used in osteotomy of minimally invasive total knee arthroplasty, reduces the risk of minimally invasive operation, and diminishes postoperative complications, but this instrument is influenced by patients’ body mass index, the length of the patellar tendon, patellar thickness, longitudinal and transverse diameter, and prosthesis model. The length of the incision should be extended for prosthesis placement.


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


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Key words: arthroplasty, replacement, knee, surgical procedures, minimally invasive, prosthesis implantation

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