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定制全膝关节:了解适应证和过程。

Custom total knee: understanding the indication and process.

机构信息

Department of Orthopaedic Surgery, Brigham Health, 75 Francis Street, Boston, MA, 02115, USA.

Department of Orthopaedic Surgery, Brigham Health, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.

出版信息

Arch Orthop Trauma Surg. 2021 Dec;141(12):2205-2216. doi: 10.1007/s00402-021-04172-9. Epub 2021 Oct 15.

Abstract

Patient-specific total knee arthroplasty (TKA) is a copy of the bony knee morphology based on a pre-op computer tomography (CT). The images are segmented in 3D and software is utilized through a proprietary process to generate individual total knee implants to recreate the articulating surfaces. The distal condylar valgus angle of the prosthesis is matched anatomically to the distal femur and reversely matched on the tibia with a thicker lateral insert. The implant, a set of patient-specific jigs (PSJ), which are 3D printed in nylon, and a detailed surgical plan are sent to the hospital in one box. The system is available with one solid or two separated medial and lateral PE inserts. There is a cruciate retaining (CR) and posterior stabilized (PS) version available, including various insert thicknesses. The system allows the addition of two different cemented stem extensions if needed at the time of surgery.

摘要

患者特异性全膝关节置换术(TKA)是根据术前计算机断层扫描(CT)对骨性膝关节形态的复制。这些图像在 3D 中进行分割,然后通过专有的软件处理来生成个体化的全膝关节植入物,以重新创建关节表面。假体的远端髁间外翻角在解剖学上与股骨远端匹配,在胫骨上与较厚的外侧衬垫反向匹配。植入物是一组患者特异性夹具(PSJ),通过尼龙 3D 打印而成,以及详细的手术计划都装在一个盒子里送到医院。该系统有一个整体式或两个分开的内侧和外侧聚乙烯衬垫可供选择。有保留交叉韧带(CR)和后稳定(PS)两种版本,包括各种不同的衬垫厚度。该系统允许在手术时根据需要添加两个不同的骨水泥固定的延长杆。

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