Deland J T, Morris G D, Sung I H
Foot and Ankle Service, Hospital for Special Surgery, Department of Orthopaedics, Joan and Sanford I. Weill Medical College of Cornell University, New York, New York, USA.
Foot Ankle Clin. 2000 Dec;5(4):747-59.
The biomechanics of the ankle present a unique set of challenges for arthroplasty surgery. Its biomechanics are not simple. Although the ankle joint may seem like a hinge, it is not in a line perpendicular to the tibia. The axis of rotation does not stay constant during range of motion, despite a relative congruency of this joint. Allowing for rotational forces must be accomplished, while maintaining the stability of the joint and its components. Success of the arthroplasty depends on how successful designs can dissipate these rotational forces, while maintaining the stability of the joint. It is not yet clear from the biomechanical analysis of the normal ankle joint that this dissipation of forces has been accomplished successfully in modern implants, although early results in the semiconstrained designs are encouraging. Careful assessment of long-term follow-up will determine how close the present designs are to mimicking the unique requirements of the arthritic foot and ankle. Further work on the biomechanics of these replacements would be beneficial.
踝关节的生物力学给关节置换手术带来了一系列独特的挑战。其生物力学并不简单。尽管踝关节看似像一个铰链，但它并不与胫骨垂直。尽管该关节相对吻合，但在运动范围内旋转轴并不恒定。在保持关节及其组成部分稳定性的同时，必须考虑旋转力。关节置换的成功取决于设计在消散这些旋转力的同时保持关节稳定性的程度。从正常踝关节的生物力学分析来看，现代植入物是否成功实现了力的消散尚不清楚，尽管半限制型设计的早期结果令人鼓舞。对长期随访的仔细评估将确定当前设计在多大程度上接近模拟患有关节炎的足踝关节的独特需求。对这些置换物的生物力学进行进一步研究将是有益的。
