单半径和多半径全膝关节整形植入物之间的松度差异在延伸时最大,在曲10°的间隙平衡时最大
Enrico M Forlenza1, Alexander D Orsi2, Christopher Plaskos2
1Department of Orthopaedic Surgery, Rush University Medical Center, Il, USA.
Journal of orthopaedics
|June 19, 2025
概括
单半径 (SR) 和多半径 (MR) 腿部植入物在膝关节置换手术中表现出不同的冠状松概况. 虽然SR植入物在延伸时具有更大的松性,但MR植入物在中间屈曲时提供更大的稳定性,尽管对齐技术对松性产生更大的影响.
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
- 医疗器械设计 医疗器械设计
背景情况:
- 带松是膝关节全关节整形术 (TKA) 结果的一个关键因素.
- Femoral 植入物设计,特别是半径,可能会影响冠状元的稳定性.
- 了解植入物设计之间的松差异对于手术规划至关重要.
研究的目的:
- 量化单半径 (SR) 与多半径 (MR) 股骨植入物设计对冠状带松的影响.
- 为了比较不同植入物设计的曲角度 (10°和90°) 的松度变化.
- 评估植入物设计或对齐技术是否对膝盖松有更大的影响.
主要方法:
- 154个使用SR植入物和反向动力对齐 (iKA) 的机器人辅助TKA的回顾性审查.
- 模拟MR植入物植入与同等大小和iKA. 的模拟.
- 用机械对齐 (MA) 技术模拟SR植入物.
- 在整个曲过程中,SR与MR和iKA与MA之间的平均中侧 (ML) 松的比较.
主要成果:
- 在0°曲时,SR植入物比MR植入物宽松度大0.7毫米.
- 与MR相比,SR植入物在20-30°曲时,在中间和侧面的松度减少了0.4毫米,而MR植入物则减少了0.4毫米.
- 在MA和iKA对齐技术之间的ML松的差异明显大 (p < 0.001) 比SR和MR植入物设计之间的差异.
结论:
- 与MR植入物相比,SR植入物在完全伸展时产生更大的松性,而在早期到中期曲时则产生更小的松性,当在10°曲时平衡时MR植入物会产生更大的松性.
- 在SR和MR植入物之间观察到的延伸宽度差异 (~1毫米) 可能具有临床意义.
- 由于对齐技术 (MA与iKA) 的冠状腺松的变化比SR和MR股骨植入物设计之间的选择所导致的变化更为明显.
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