在全膝关节整形术中重新定义了骨骨关节填充的概念
Jobe Shatrov1, Benoit Coulin2, Cécile Batailler3
1Landmark Orthopaedics, St. Leonards, Sydney, Australia; The University of Sydney, Australia; Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France.
Journal of ISAKOS : joint disorders & orthopaedic sports medicine
|November 22, 2024
概括
在全膝关节整形术 (TKA) 中,在全延伸的情况下重建本土三关节空间经常导致腿骨关节 (PFJ) 在曲中失衡. 超过40%的TKA在中到深度曲中经历过多或过少的填充.
科学领域:
- 整形外科手术 整形外科手术
- 生物机械工程 生物机械工程
- 医疗器械技术 医疗器械技术
背景情况:
- 骨骨关节 (PFJ) 的平衡在全膝关节整形术 (TKA) 中至关重要,以防止过度填充.
- 为了实现最佳的PFJ动力学,需要在整个运动范围内精确地放置组件.
研究的目的:
- 为了评估重建本地三角膜深度在中间和深度曲时的频率,当前侧翼被放置以匹配完全延伸时.
- 评估一项专注于恢复全延伸三关节空间的战略在曲过程中对PFJ平衡的影响.
主要方法:
- 在122名患者身上进行了机器人辅助的TKA.
- 腿部部件是使用功能性对齐放置的,目标是前侧翼在2毫米内的本土解剖在0度的屈曲.
- 胸腔深度恢复在全伸展,中折 (30-40°) 和深折 (80-90°) 时被测量,在2毫米的本土解剖范围内定义平衡.
主要成果:
- 100%的TKA实现了完全延伸的平衡三叶.
- 54%的TKA (54/122) 在中度或深度曲中被过度填充或填充不足.
- 在中曲折中,32%的人没有充分填充;在深曲折中,20.5%的人过度填充,24.6%的人没有充分填充.
结论:
- 基于完全延伸的股骨部件的定位可能会导致超过40%的TKAs在曲中显著的PFJ过度或不足填充.
- 失衡率在中间和深度曲时是相似的,而在中间曲时,不足的装备更为普遍.
- 目前在TKA中对PFJ平衡的概念可能需要修订,以考虑整个曲弧,而不足填充的临床影响需要进一步调查.
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