不同类型膝关节后稳定型假体髁间截骨量的对比

发布时间：2018-06-19 03:44

本文选题：关节成形术 + 置换　；参考：《中国组织工程研究》2015年39期

【摘要】：背景:后稳定型膝关节假体股骨侧需要额外的髁间截骨来容纳胫骨柱和股骨窝结构,髁间窝两侧与股骨体相连处应力集中是骨折好发部位。不同品牌假体不同型号间截骨量的差异并没有具体数据,不便于临床医生在选择假体时参考。目的:比较临床上常用的后稳定型膝关节假体(进口、国产的6个品牌)髁间截骨数据的不同,为临床假体选择和应用提供依据。方法:选择目前国内常用的(进口、国产的6个品牌)后稳定型人工膝关节假体,包括Zimmer Nex Gen LPS、Stryker Scrorpio NRG Knee-Flexed、Depuy PFC Sigma、Smithnephew Genesis-2 PS、United-U1及威高GKPS。根据截骨模板确定截骨面包括股骨髁前截面、后截部、股骨髁远端截面、后斜截面;对应股骨假体径线包括髁内外径宽、髁前后径宽、股骨髁间窝截骨宽度及深度,对上述数据进行对比测量。结果与结论:6种膝关节股骨髁假体的前后径/内外径、髁间窝截骨量及形态均存在差异,国外品牌股骨远端前后截骨面间径线较短,对后髁的截骨程度较大。随着应用假体尺寸的增大,所用品牌髁间截骨宽度所致骨量丢失比例均呈下降趋势,无论是小尺寸假体还是大尺寸假体,Stryker Scrorpio NRG Knee-Flexed假体髁间截骨宽度均较小。6个品牌的膝关节假体截骨尺寸有所不同,以上结果并不足以评价不同假体之间的优劣,但就保留髁间骨储量而言,髁间截骨量少的设计较具优势。
[Abstract]:Background: additional intercondylar osteotomy is needed to accommodate the tibial column and the femoral fossa structure on the femur side of the posterior stable knee prosthesis. The stress concentration on both sides of the intercondylar fossa is the most common site of fracture. There is no specific data on osteotomy volume between different models of prosthesis, which is not convenient for clinicians to refer to when selecting prosthesis. Objective: to compare the data of intercondylar osteotomy of posterior stable knee joint prosthesis (imported, 6 brands made in China), so as to provide evidence for selection and application of clinical prosthesis. Methods: Post-stable artificial knee prosthesis was selected, including Zimmer Nex Genesis-2 PSV United-U1, Zimmer Nex Gen LPS-Stryker Scrorpio NRG Knee-Flexedn Depuy PFC Sigma-Smithnephew Genesis-2 PSV United-U1. According to the osteotomy template, the osteotomy surface includes the anterior section of the femoral condyle, the posterior section of the femoral condyle, the distal section of the femoral condyle and the posterior oblique section. Compare and measure the above data. Results and conclusion there were differences in the anteroposterior / outer diameters of 6 kinds of femoral condylar prostheses, the amount and shape of intercondylar fossa osteotomy. The interfacial diameters of distal femur osteotomy in foreign brands were shorter, and the osteotomy degree of posterior condyle was higher. With the increase of the size of the prosthesis, the proportion of bone loss caused by the intercondylar osteotomy width of the brand decreased. The intercondylar osteotomy width of small size prosthesis or large size prosthesis is smaller. The above results are not enough to evaluate the advantages and disadvantages of different prostheses. However, in terms of reserve of intercondylar bone, the design with less intercondylar osteotomy is superior.
【作者单位】：中山大学孙逸仙纪念医院关节外科;中山大学;
【基金】：广东省科技计划项目(2014A020215009)~~
【分类号】：R318.17

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