O'Connor J J, Goodfellow J W
Oxford Orthopaedic Engineering Centre, University of Oxford.
Proc Inst Mech Eng H. 1996;210(3):217-22. doi: 10.1243/PIME_PROC_1996_210_415_02.
This paper attributes the high rate of high-density polyethylene (HDP) wear in many knee prostheses to incongruity of their articular surfaces. The authors discuss the anatomical and kinematic features of the knee which have led most designers to choose incongruous surfaces and review the reasons for employing free bearings, analogues of the natural menisci, to provide congruity without restriction of movement. There are theoretical reasons against employing freely mobile bearing in the absence of a functioning anterior cruciate ligament (ACL) and the authors' experience has confirmed this limitation in practice. It is concluded that, in bicompartmental replacement, the movements of the meniscal bearing should be limited in the anteroposterior direction. For unicompartmental arthritis, an unconstrained bearing can be employed if, as is usually the case, all ligaments are intact.
本文将许多膝关节假体中高密度聚乙烯（HDP）磨损率高归因于其关节面不匹配。作者讨论了膝关节的解剖学和运动学特征，这些特征导致大多数设计者选择不匹配的表面，并回顾了采用自由轴承（天然半月板的类似物）以在不限制运动的情况下提供匹配性的原因。在没有功能性前交叉韧带（ACL）的情况下，有理论依据反对使用自由活动轴承，作者的经验也已在实践中证实了这一局限性。得出的结论是，在双髁置换中，半月板轴承的运动应在前后方向上受到限制。对于单髁关节炎，如果所有韧带通常都完好无损，则可以采用无约束轴承。
