Advanced 3D imaging and CT-based navigation have emerged as valuable tools to use in total knee arthroplasty (TKA), for both preoperative planning and the intraoperative execution of different philosophies of alignment. Preoperative planning using CT-based 3D imaging enables more accurate prediction of the size of components, enhancing surgical workflow and optimizing the precision of the positioning of components. Surgeons can assess alignment, osteophytes, and arthritic changes better. These scans provide improved insights into the patellofemoral joint and facilitate tibial sizing and the evaluation of implant-bone contact area in cementless TKA. Preoperative CT imaging is also required for the development of patient-specific instrumentation cutting guides, aiming to reduce intraoperative blood loss and improve the surgical technique in complex cases. Intraoperative CT-based navigation and haptic guidance facilitates precise execution of the preoperative plan, aiming for optimal positioning of the components and accurate alignment, as determined by the surgeon's philosophy. It also helps reduce iatrogenic injury to the periarticular soft-tissue structures with subsequent reduction in the local and systemic inflammatory response, enhancing early outcomes. Despite the increased costs and radiation exposure associated with CT-based navigation, these many benefits have facilitated the adoption of imaged based robotic surgery into routine practice. Further research on ultra-low-dose CT scans and exploration of the possible translation of the use of 3D imaging into improved clinical outcomes are required to justify its broader implementation.

中文翻译：

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目前CT在全膝关节置换术中的作用。


先进的 3D 成像和基于 CT 的导航已成为全膝关节置换术 (TKA) 中的宝贵工具，可用于术前规划和术中执行不同的对位理念。使用基于 CT 的 3D 成像进行术前规划可以更准确地预测组件的尺寸，从而增强手术流程并优化组件定位的精度。外科医生可以更好地评估排列、骨赘和关节炎变化。这些扫描可以更好地了解髌股关节，并有助于在非骨水泥 TKA 中确定胫骨尺寸和评估植入物与骨的接触面积。术前CT成像还需要开发针对患者的器械切割导板，旨在减少术中失血并提高复杂病例的手术技术。术中基于 CT 的导航和触觉引导有助于精确执行术前计划，旨在根据外科医生的理念确定组件的最佳定位和准确对准。它还有助于减少对关节周围软组织结构的医源性损伤，从而减少局部和全身炎症反应，从而增强早期结果。尽管与基于 CT 的导航相关的成本和辐射暴露增加，但这些好处促进了基于图像的机器人手术在常规实践中的采用。需要对超低剂量 CT 扫描进行进一步研究，并探索将 3D 成像的使用转化为改善临床结果的可能性，以证明其更广泛实施的合理性。