Delp S L, Stulberg S D, Davies B, Picard F, Leitner F
Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA.
Clin Orthop Relat Res. 1998 Sep(354):49-56. doi: 10.1097/00003086-199809000-00007.
Accurate alignment of knee implants is essential for the success of total knee replacement. Although mechanical alignment guides have been designed to improve alignment accuracy, there are several fundamental limitations of this technology that will inhibit additional improvements. Various computer assisted techniques have been developed to examine the potential to install knee implants more accurately and consistently than can be done with mechanical guides. For example, computer integrated instrumentation incorporates highly accurate measurement devices to locate joint centers, track surgical tools, and align prosthetic components. Image guided knee replacement provides a three-dimensional preoperative plan that guides the placement of the cutting blocks and prosthetic components. Robot assisted knee replacement allows one to machine bones accurately without the use of standard cutting blocks. The rationale for the development of computer assisted knee replacement systems is presented, the operation of several different systems is described, the advantages and disadvantages of different approaches are discussed, and areas for future research are suggested.
膝关节植入物的精确对线对于全膝关节置换术的成功至关重要。尽管已经设计了机械对线导向装置来提高对线精度，但这项技术存在一些基本局限性，将阻碍进一步改进。已经开发了各种计算机辅助技术，以研究比机械导向装置更准确、更一致地安装膝关节植入物的潜力。例如，计算机集成器械结合了高精度测量设备，以定位关节中心、跟踪手术工具并对齐假体组件。图像引导膝关节置换提供了一个三维术前计划，用于指导切割块和假体组件的放置。机器人辅助膝关节置换允许在不使用标准切割块的情况下精确加工骨骼。本文介绍了计算机辅助膝关节置换系统的开发原理，描述了几种不同系统的操作，讨论了不同方法的优缺点，并提出了未来研究的领域。
