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高屈曲度全膝关节置换设计中的生物力学考量

Biomechanical considerations in the design of high-flexion total knee replacements.

作者信息

Cheng Cheng-Kung, McClean Colin J, Lai Yu-Shu, Chen Wen-Chuan, Huang Chang-Hung, Lin Kun-Jhih, Chang Chia-Ming

机构信息

Institute of Biomedical Engineering, National Yang-Ming University, No. 155, Section 2, Linong Street, Beitou District, Taipei 11221, Taiwan ; Orthopaedic Device Research Center, National Yang-Ming University, No. 155, Section 2, Linong Street, Beitou District, Taipei 11221, Taiwan.

Institute of Biomedical Engineering, National Yang-Ming University, No. 155, Section 2, Linong Street, Beitou District, Taipei 11221, Taiwan.

出版信息

ScientificWorldJournal. 2014;2014:205375. doi: 10.1155/2014/205375. Epub 2014 May 6.

DOI:10.1155/2014/205375
PMID:24892040
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4032730/
Abstract

Typically, joint arthroplasty is performed to relieve pain and improve functionality in a diseased or damaged joint. Total knee arthroplasty (TKA) involves replacing the entire knee joint, both femoral and tibial surfaces, with anatomically shaped artificial components in the hope of regaining normal joint function and permitting a full range of knee flexion. In spite of the design of the prosthesis itself, the degree of flexion attainable following TKA depends on a variety of factors, such as the joint's preoperative condition/flexion, muscle strength, and surgical technique. High-flexion knee prostheses have been developed to accommodate movements that require greater flexion than typically achievable with conventional TKA; such high flexion is especially prevalent in Asian cultures. Recently, computational techniques have been widely used for evaluating the functionality of knee prostheses and for improving biomechanical performance. To offer a better understanding of the development and evaluation techniques currently available, this paper aims to review some of the latest trends in the simulation of high-flexion knee prostheses.

摘要

通常情况下,进行关节置换术是为了缓解患病或受损关节的疼痛并改善其功能。全膝关节置换术(TKA)包括用解剖形状的人工部件替换整个膝关节,即股骨和胫骨表面,以期恢复正常关节功能并实现膝关节的全范围屈曲。尽管假体本身有其设计,但TKA术后可达到的屈曲程度取决于多种因素,如关节的术前状况/屈曲度、肌肉力量和手术技术。高屈曲度膝关节假体已被研发出来,以适应比传统TKA通常所能达到的更大屈曲度的运动;这种高屈曲度在亚洲文化中尤为普遍。最近,计算技术已被广泛用于评估膝关节假体的功能和改善生物力学性能。为了更好地理解目前可用的开发和评估技术,本文旨在综述高屈曲度膝关节假体模拟方面的一些最新趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b521/4032730/d74272c72bef/TSWJ2014-205375.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b521/4032730/f705a84fa775/TSWJ2014-205375.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b521/4032730/ba6ab573acac/TSWJ2014-205375.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b521/4032730/d74272c72bef/TSWJ2014-205375.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b521/4032730/f705a84fa775/TSWJ2014-205375.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b521/4032730/ba6ab573acac/TSWJ2014-205375.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b521/4032730/d74272c72bef/TSWJ2014-205375.003.jpg

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本文引用的文献

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Cochrane Database Syst Rev. 2013 Oct 11;2013(10):CD004803. doi: 10.1002/14651858.CD004803.pub3.
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Effect of implant design on knee flexion.种植体设计对膝关节弯曲的影响。
J Arthroplasty. 2013 Mar;28(3):429-38. doi: 10.1016/j.arth.2012.07.019. Epub 2012 Dec 6.
3
The effects of implantation of tibio-femoral components in hyperextension on kinematics of TKA.
全膝关节置换术中胫骨-股骨组件在过伸位植入对关节运动学的影响。
Knee Surg Sports Traumatol Arthrosc. 2012 Oct;20(10):2032-8. doi: 10.1007/s00167-011-1829-x. Epub 2011 Dec 20.
4
Mimicking anatomical condylar configuration into knee prosthesis could improve knee kinematics after TKA - a computational simulation.在膝关节假体中模仿解剖学髁突形态可改善全膝关节置换术后的膝关节运动学——一项计算机模拟研究。
Clin Biomech (Bristol). 2012 Feb;27(2):176-81. doi: 10.1016/j.clinbiomech.2011.08.010. Epub 2011 Sep 10.
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Influence of post-cam design of posterior stabilized knee prosthesis on tibiofemoral motion during high knee flexion.后稳定型膝关节假体的后凸轮设计对高屈膝时胫股关节运动的影响。
Clin Biomech (Bristol). 2011 Oct;26(8):847-52. doi: 10.1016/j.clinbiomech.2011.04.002. Epub 2011 May 5.
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Anatomic-like polyethylene insert could improve knee kinematics after total knee arthroplasty--a computational assessment.解剖型聚乙烯垫片可改善全膝关节置换术后的膝关节运动学——一项计算评估。
Clin Biomech (Bristol). 2011 Jul;26(6):612-9. doi: 10.1016/j.clinbiomech.2011.01.013. Epub 2011 Mar 4.
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Knee kinematics of high-flexion activities of daily living performed by male Muslims in the Middle East.中东地区的穆斯林男性在日常生活中进行高屈曲活动时的膝关节运动学。
J Arthroplasty. 2011 Feb;26(2):319-27. doi: 10.1016/j.arth.2010.08.003. Epub 2010 Oct 29.
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A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the NexGen standard and high flexion components.一项关于使用NexGen标准组件和高屈曲组件进行全膝关节置换术后功能结果和屈曲范围的前瞻性随机双盲研究。
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