机械与动力对齐后的股骨形态使用设计用于机械对齐的中枢植入物:基于CT的比较研究
Yohei Ohyama1,2, Yukihide Minoda2, Sho Masuda2
1Department of Orthopaedic Surgery, Osaka Rosai Hospital, Osaka, Japan.
概括
在全膝关节整形手术 (TKA) 中,运动对齐 (KA) 与机械对齐 (MA) 相比,导致不同的后腿状骨形态. 外科医生应考虑植入物大小或特定的植入物以获得最佳结果.
科学领域:
- 骨科手术
- 生物医学工程
- 放射学
背景情况:
- 运动对齐 (KA) 旨在在全膝关节整形术 (TKA) 中复制本地关节解剖学.
- 股骨尾 (PLOF) 的后侧纵向突起是影响TKA结果的关键形态参数.
- 了解对齐技术之间的PLOF差异对于优化TKA植入物适合和功能至关重要.
研究的目的:
- 在中枢膝关节整形术 (TKA) 后,比较大腿骨的后侧纵向突起 (PLOF).
- 评估动力调整 (KA) 和机械调整 (MA) 技术之间的PLOF差异.
- 在KA TKA中调查大腿形态和PLOF之间的相关性.
主要方法:
- 对50个经过单侧TKA的膝关节进行回顾式计算机断层扫描 (CT) 分析,以检测中枢膝关节关节炎.
- 在术前CT扫描中使用KA和MA协议的部部件计算机辅助设计 (FC-CAD) 模型的定位.
- 测量中部和侧部PLOF,远部/后部大腿切除,并分析大腿形态参数.
主要成果:
- 与机械对齐相比,动力对齐 (KA) 显示中部PLOF (3.8 mm) 显著增加,侧面PLOF (3.4 mm) 显著减少.
- 与KA相比,机械对齐 (MA) 导致杆对齐减少和外部旋转增加.
- 没有发现与KA相关的PLOF和测量的股骨形态参数之间的显著相关性,这表明存在不匹配.
结论:
- 与TKA中的机械对齐 (MA) 相比,运动对齐 (KA) 显著改变了中间和侧面的尾形态.
- 观察到的缺乏相关性表明在使用KA时,原生骨和面向MA的假肢之间可能存在不匹配.
- 外科医生应考虑缩小植入物或使用KA特有的组件,以优化使用KA与中枢TKA的结果.
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