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[前交叉韧带完整的膝关节骨关节炎患者行部分膝关节置换术的联合应用——一种未来模式?]

[The combination of partial knee arthroplasties in knee osteoarthritis with an intact anterior cruciate ligament - a future model?].

作者信息

Calliess Tilman, Christen Bernhard, Theus-Steinmann Carlo

机构信息

articon Spezialpraxis für Gelenkchirurgie, Berner Prothetikzentrum, Salem-Spital, Schänzlistrasse 39, 3013, Bern, Schweiz.

出版信息

Orthopadie (Heidelb). 2024 Apr;53(4):255-264. doi: 10.1007/s00132-024-04482-x. Epub 2024 Mar 7.

Abstract

BACKGROUND

Preserving both cruciate ligaments in knee prosthetics enables approximately physiological joint kinematics. In this way, faster rehabilitation and a higher return-to-sports rate can be achieved. Accordingly, there are considerations to preserve both cruciate ligaments by combining two partial prostheses in the case of symptomatic bicompartmental (BiCom) knee osteoarthritis.

METHODS

This article summarizes the literature on BiCom arthroplasty and describes our own experiences from 54 consecutive cases with robotic-assisted technology.

RESULTS

According to current data, BiCom arthroplasty shows good clinical results, without being able to demonstrate a clear advantage over conventional TKA. The revision risk is slightly increased in the short-term interval, which could be positively addressed with robotic-assistance. The disadvantages are the increased implant costs and the risk of subsequent osteoarthritis. Accordingly, patients who may potentially take advantage of this treatment must be critically selected.

摘要

背景

在膝关节假体中保留两条交叉韧带可实现近似生理状态的关节运动学。通过这种方式,可以实现更快的康复和更高的重返运动率。因此,对于有症状的双间室(BiCom)膝关节骨关节炎患者,存在通过组合两个部分假体来保留两条交叉韧带的考虑。

方法

本文总结了关于双间室关节成形术的文献,并描述了我们在54例连续病例中使用机器人辅助技术的经验。

结果

根据目前的数据,双间室关节成形术显示出良好的临床效果,但未能证明其比传统全膝关节置换术有明显优势。在短期内,翻修风险略有增加,而机器人辅助可以对此进行积极应对。缺点是植入物成本增加以及后续骨关节炎的风险。因此,必须严格挑选可能从这种治疗中获益的患者。

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