Small Scott R, Berend Michael E, Ritter Merrill A, Buckley Christine A
Joint Replacement Surgeons of Indiana Research Foundation, Mooresville, IN, USA.
Surg Technol Int. 2010 Apr;19:185-90.
Mobile-bearing unicompartmental knees facilitate decreased polyethylene wear and restoration of knee kinematics. The purpose of this study was to quantify tibial strains during bearing mobility in UKA. Composite tibiae were implanted with cemented metal-backed tibial components and coated with photoelastic material, allowing "full-field" strain analysis. A fully congruent mobile polyethylene bearing was loaded in six separate locations on the tibial tray, simulating bearing translation during knee motion. Strains were noted to be greatest in the anteromedial tibia, 2 cm distal to the joint line, which correlates with the area occasionally noted to have residual pain following UKA. This study demonstrates the important role that bearing movement plays in load distribution throughout the tibia after UKA and may illuminate a biomechanical process of tibial remodeling that influences pain and implant loosening.
活动平台单髁膝关节有助于减少聚乙烯磨损并恢复膝关节运动学。本研究的目的是量化单髁膝关节置换术中活动平台期间的胫骨应变。复合胫骨植入骨水泥固定的金属背衬胫骨组件,并涂有光弹性材料,可进行“全场”应变分析。一个完全贴合的活动聚乙烯垫片在胫骨托的六个不同位置加载,模拟膝关节运动期间垫片的平移。结果发现,在关节线远端2厘米处的胫骨前内侧应变最大,这与单髁膝关节置换术后偶尔出现残余疼痛的区域相关。本研究证明了垫片运动在单髁膝关节置换术后胫骨整体负荷分布中所起的重要作用,并可能阐明影响疼痛和植入物松动的胫骨重塑生物力学过程。