Zanasi Stefano
Third Division-MIS Hip and Knee Joint Arthroplasty Operative Centre, Orthopaedics Department, Gruppo San Donato, Villa Erbosa Hospital, Bologna, Italy.
Eur Orthop Traumatol. 2011 Jul;2(1-2):21-31. doi: 10.1007/s12570-011-0066-6. Epub 2011 Jul 13.
The human knee joint can sustain damage due to injury, or more usually osteoarthritis, to one, two or all three of the knee compartments: the medial femorotibial, the lateral femorotibial and the patellofemoral compartments. When pain associated with this damage is unmanageable using nonsurgical techniques, knee replacement surgery might be the most appropriate course of action. This procedure aims to restore a pain-free, fully functional and durable knee joint. Total knee replacement is a well-established treatment modality, and more recently, partial knee replacement-more commonly known as bi- or unicompartmental knee replacement-has seen resurgence in interest and popularity. Combined with the use of minimally invasive surgery (MIS) techniques, gender-specific prosthetics and computer-assisted navigation systems, orthopaedic surgeons are now able to offer patients knee replacement procedures that are associated with (1) minimal risks during and after surgery by avoiding fat embolism, reducing blood loss and minimising soft tissue disruption; (2) smaller incisions; (3) faster and less painful rehabilitation; (4) reduced hospital stay and faster return to normal activities of daily living; (5) an improved range of motion; (6) less requirement for analgesics; and (7) a durable, well-aligned, highly functional knee. With the ongoing advancements in surgical technique, medical technology and prosthesis design, knee replacement surgery is constantly evolving. This review provides a personal account of the recent innovations that have been made, with a particular emphasis on the potential use of MIS techniques combined with computer-assisted navigation systems to treat younger, more physically active patients with resurfacing partial/total implant knee arthroplasty.
人类膝关节可能因受伤，或更常见的骨关节炎，而受到一个、两个或全部三个膝关节腔室的损伤：内侧股胫关节腔、外侧股胫关节腔和髌股关节腔。当使用非手术技术无法控制与这种损伤相关的疼痛时，膝关节置换手术可能是最合适的治疗方法。该手术旨在恢复无痛、功能完全正常且持久耐用的膝关节。全膝关节置换是一种成熟的治疗方式，最近，部分膝关节置换——更常见的是双髁或单髁膝关节置换——重新受到关注并越来越受欢迎。结合使用微创手术（MIS）技术、针对性别的假体和计算机辅助导航系统，骨科医生现在能够为患者提供膝关节置换手术，这些手术具有以下优点：（1）通过避免脂肪栓塞、减少失血和最小化软组织损伤，使手术中和手术后的风险降至最低；（2）切口更小；（3）康复更快且疼痛更少；（4）住院时间缩短，更快恢复正常日常生活活动；（5）活动范围改善；（6）对镇痛药的需求减少；（7）膝关节耐用、排列良好且功能高度正常。随着手术技术、医疗技术和假体设计的不断进步，膝关节置换手术也在不断发展。本综述介绍了最近的创新成果，特别强调了微创手术技术与计算机辅助导航系统结合用于治疗更年轻、身体活动更多的患者进行表面置换部分/全膝关节置换术的潜在用途。
