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单髁膝关节置换术中胫骨平台覆盖情况:定制型与通用型植入物的比较

Tibial plateau coverage in UKA: a comparison of patient specific and off-the-shelf implants.

作者信息

Carpenter Dylan P, Holmberg Rebecca R, Quartulli Marc J, Barnes C Lowry

机构信息

University of Arkansas for Medical Sciences, Little Rock, Arkansas.

CONFORMIS, Inc., Bedford, Massachusetts.

出版信息

J Arthroplasty. 2014 Sep;29(9):1694-8. doi: 10.1016/j.arth.2014.03.026. Epub 2014 Mar 28.

Abstract

Poor tibial component fit can lead to issues including pain, loosening and subsidence. Morphometric data, from 30 patients undergoing UKA were utilized; comparing size, match and fit between patient-specific and off-the-shelf implants. CT images were prospectively obtained and implants modeled in CAD, utilizing sizing templates with off-the-shelf and CAD designs with patient-specific implants. Virtual surgery was performed, maximizing tibial plateau coverage while minimizing implant overhang. Each implant evaluated to examine tibial fit. Patient-specific implants provided significantly greater cortical rim surface area coverage versus off-the-shelf implants: 77% v. 43% medially and 60% v. 37% laterally. Significantly less cortical rim overhang and undercoverage were observed with patient-specific implants. Patient-specific implants provide superior cortical bone coverage and fit while minimizing overhang and undercoverage seen in off-the-shelf implants.

摘要

胫骨假体安装不当会导致包括疼痛、松动和下沉等问题。利用了30例行单髁膝关节置换术患者的形态学数据,比较定制假体和现成假体之间的尺寸、匹配度和安装情况。前瞻性地获取CT图像,并在CAD中对假体进行建模,现成假体使用尺寸模板,定制假体使用CAD设计。进行虚拟手术,在使胫骨平台覆盖最大化的同时,使假体悬垂最小化。对每个假体进行评估以检查胫骨的安装情况。与现成假体相比,定制假体提供了显著更大的皮质边缘表面积覆盖率:内侧分别为77%对43%,外侧分别为60%对37%。定制假体的皮质边缘悬垂和覆盖不足明显更少。定制假体提供了更好的皮质骨覆盖和安装效果,同时使现成假体中出现的悬垂和覆盖不足最小化。

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