Lee Jin-Ah, Koh Yong-Gon, Kang Kyoung-Tak
Department of Mechanical Engineering, Yonsei University, Seoul 50, Korea.
Joint Reconstruction Center and Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Soeul 478-3, Korea.
J Clin Med. 2020 May 21;9(5):1559. doi: 10.3390/jcm9051559.
(1) Background: Although knee arthroplasty or knee replacement is already an effective clinical treatment, it continues to undergo clinical and biomechanical improvements. For an increasing number of conditions, prosthesis based on an individual patient's anatomy is a promising treatment. The aims of this review were to evaluate the clinical and biomechanical efficacy of patient-specific knee prosthesis, explore its future direction, and summarize any published comparative studies. (2) Methods: We searched the PubMed, MEDLINE, Embase, and Scopus databases for articles published prior to February 1, 2020, with the keywords "customized knee prosthesis" and "patient-specific knee prosthesis". We excluded patient-specific instrument techniques. (3) Results: Fifty-seven articles met the inclusion criteria. In general, clinical improvement was greater with a patient-specific knee prosthesis than with a conventional knee prosthesis. In addition, patient-specific prosthesis showed improved biomechanical effect than conventional prosthesis. However, in one study, patient-specific unicompartmental knee arthroplasty showed a relatively high rate of aseptic loosening, particularly femoral component loosening, in the short- to medium-term follow-up. (4) Conclusions: A patient-specific prosthesis provides a more accurate resection and fit of components, yields significant postoperative improvements, and exhibits a high level of patient satisfaction over the short to medium term compared with a conventional prosthesis. However, the tibial insert design of the current patient-specific knee prosthesis does not follow the tibial plateau curvature.
(1) 背景：尽管膝关节置换术已是一种有效的临床治疗方法，但仍在不断进行临床和生物力学方面的改进。对于越来越多的病症，基于个体患者解剖结构的假体是一种很有前景的治疗方法。本综述的目的是评估定制膝关节假体的临床和生物力学疗效，探索其未来方向，并总结已发表的比较研究。(2) 方法：我们在PubMed、MEDLINE、Embase和Scopus数据库中检索了2020年2月1日前发表的文章，关键词为“定制膝关节假体”和“患者特异性膝关节假体”。我们排除了患者特异性器械技术。(3) 结果：57篇文章符合纳入标准。总体而言，定制膝关节假体的临床改善效果优于传统膝关节假体。此外，定制假体的生物力学效果也优于传统假体。然而，在一项研究中，定制单髁膝关节置换术在短期至中期随访中显示出相对较高的无菌性松动率，尤其是股骨部件松动。(4) 结论：与传统假体相比，定制假体能够更精确地切除和安装部件，术后有显著改善，并且在短期至中期显示出较高的患者满意度。然而，目前定制膝关节假体的胫骨衬垫设计并未遵循胫骨平台的曲率。
