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单髁膝关节置换术的适应症及机器人手臂辅助技术的原理。

Indications for unicompartmental knee arthroplasty and rationale for robotic arm-assisted technology.

作者信息

Lonner Jess H

机构信息

Pennsylvania Hospital, Philadelphia, Pennsylvania 19107, USA.

出版信息

Am J Orthop (Belle Mead NJ). 2009 Feb;38(2 Suppl):3-6.

Abstract

Unicompartmental knee arthroplasty (UKA) is an effective surgical treatment for focal arthritis when appropriate selection criteria are followed. Although results can be optimized with careful patient selection and use of a sound implant design, two of the most important determinants of UKA performance and durability are how well the bone is prepared and components aligned. Study results have shown that component malalignment by as little as 2 degrees may predispose to implant failure after UKA. Conventional cutting guides have been relatively inaccurate in determining alignment and preparing the bone surfaces for unicompartmental implants. Computer navigation has improved component alignment to an extent, but outliers still exist. The introduction of robotics capitalizes on the virtues of computer navigation but couples the planning and mapping of navigation with robotic techniques for bone preparation. Robotic technology is fostering substantially improved precision and component alignment in UKA, even when using minimally invasive soft-tissue approaches.

摘要

单髁膝关节置换术(UKA)在遵循适当的选择标准时,是治疗局限性关节炎的一种有效手术方法。尽管通过仔细的患者选择和使用合理的植入物设计可以优化结果,但UKA性能和耐用性的两个最重要决定因素是骨准备的质量和组件的对齐情况。研究结果表明,UKA后组件错位小至2度可能会导致植入物失败。传统的切割导板在确定对齐和为单髁植入物准备骨表面方面相对不准确。计算机导航在一定程度上改善了组件对齐,但仍存在异常情况。机器人技术的引入利用了计算机导航的优点,但将导航的规划和映射与骨准备的机器人技术相结合。即使采用微创软组织入路,机器人技术也在大幅提高UKA的精度和组件对齐。

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