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[膝关节置换翻修部件的生物力学方面]

[Biomechanical aspects of revision components for knee arthroplasty].

作者信息

Steinhauser E, Burgkart R, Gerdesmeyer L

机构信息

Abteilung Biomechanik, Klinik für Orthopädie und Unfallchirurgie, Technische Universität, München.

出版信息

Orthopade. 2006 Feb;35(2):128-35. doi: 10.1007/s00132-005-0911-9.

Abstract

Total knee arthroplasty (TKA) is one of the most frequent orthopaedic surgical procedures. Despite continuous improvements in the endoprostheses, instruments, and operative techniques, revision TKA has a rate of about 10% of overall TKA. In addition to the restoration of the periprosthetic bone stock and a precise alignment, the choice of an adequate implant, which meets the patient's specific requirements, has high impact on the outcome. The most significant differences between implants involve the degree of reconstructed joint area (uni-, bi-, tri-compartimental) and the order of the constraining forces between the femoral and tibial component. Implants for revision TKA commonly range from un- or semiconstrained resurfacing implants to fully constrained hinged endoprostheses. In case of severe osseous, ligamentous, and/or muscular defects, special tumor endoprostheses or implants for arthrodesis might be an alternative option.

摘要

全膝关节置换术(TKA)是最常见的骨科手术之一。尽管人工关节假体、器械和手术技术不断改进,但翻修全膝关节置换术在全膝关节置换术中的比例约为10%。除了恢复假体周围的骨量和精确对线外,选择符合患者特定需求的合适植入物对手术结果有很大影响。植入物之间最显著的差异在于重建关节面积的程度(单髁、双髁、三髁)以及股骨和胫骨组件之间约束力的顺序。翻修全膝关节置换术的植入物通常从不约束或半约束表面置换植入物到完全约束的铰链式人工关节假体。在存在严重骨、韧带和/或肌肉缺损的情况下,特殊的肿瘤人工关节假体或关节融合植入物可能是一种替代选择。

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