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在多次修复全膝关节整形术中使用定制植入物挽救四肢:当袖子和不再是选择时
Stefanie Donner1, Clemens Gwinner1, Henryk Haffer1
1Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery (CMSC) Berlin Germany.
Journal of experimental orthopaedics
|January 21, 2026
概括
定制膝盖植入物为复杂修复膝盖全关节整形术 (rTKA) 病例提供了可行的解决方案,这些病例具有严重的骨缺陷. 这些针对患者的植入物显示出有希望的中期结果,改善功能,并在标准选择失败时减少疼痛.
科学领域:
- 整形外科手术 整形外科手术
- 生物材料工程 生物材料工程
- 医疗器械设计 医疗器械设计
背景情况:
- 修复全膝关节整形术 (rTKA) 是复杂的,特别是严重的骨缺陷.
- 在这些具有挑战性的情况下,标准植入物往往无法提供足够的固定.
- 定制植入物为复杂的骨重建提供了潜在的解决方案.
研究的目的:
- 为了评估临床结果,生存率和定制膝盖植入物的并发症在无菌的一级rTKA.
- 评估定制植入物在标准植入物不适合的严重骨缺陷中的有效性.
- 为了比较定制和标准选项之间的植入物成本.
主要方法:
- 在16名患有安德森整形医学研究所 (AORI) 类型III骨缺陷的患者中,使用定制植入物进行了18次单阶段RTKA.
- 患者平均有五次之前的手术.
- 用KOOS,OKS,VAS疼痛得分,ROM和步行时间来评估临床结果.
主要成果:
- 平均随访时间为51个月.
- 在KOOS (31至80,p<0.001) 和OKS (47至32,p<0.001) 中观察到显著改善.
- 疼痛 (VAS) 从8.1降至3.1 (p<0.001),其中17%的人出现并发症.
结论:
- 定制植入物为患有严重纵向骨缺陷的患者提供了一阶段RTKA的有希望的无水泥合并填充固定.
- 当标准修复植入物不足时,这些植入物特别有益.
- 中期结果表明有效性,但需要来自较大的队列的长期数据.
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