膝关节置换假体研究进展
|
摘要
在全球范围内,成功率很高的膝关节置换手术缓解了终末期膝关节骨性关节炎患者的膝关节疼痛并改善了他们的膝关节功能,提高了生活质量。膝关节置换手术技术经历了40多年的快速发展,已相对成熟。而各种膝关节置换用假体的设计特点各异,且种类繁多,应用指征不尽相同。为不同的膝关节置换患者选择合适的假体是人工膝关节置换取得良好疗效的基础。本文介绍了不同膝关节置换假体设计的特点以及假体性能的优缺点,概括了不同假体类型的应用原则及其疗效,并对膝关节假体的发展趋势进行了综述。
Globally, knee arthroplasty is successfully used to alleviate knee pain, improve knee function and quality of lifein patients with end-stage knee osteoarthritis. With the development more than 40 years, knee arthroplasty become a matured treatment technique. However, the diverse prostheses with varied design characteristics have different indication for clinical applications, and choosing the correct prosthesis is the basis of sound results of artificial knee arthroplasty. This article introduces the characteristics of prosthesis design, the advantages and disadvantages of prosthesis performance, as well as discusses the application principles of different types of prosthesis, their clinical consequences, and the tendency of knee prosthesis development.
Globally, knee arthroplasty is successfully used to alleviate knee pain, improve knee function and quality of lifein patients with end-stage knee osteoarthritis. With the development more than 40 years, knee arthroplasty become a matured treatment technique. However, the diverse prostheses with varied design characteristics have different indication for clinical applications, and choosing the correct prosthesis is the basis of sound results of artificial knee arthroplasty. This article introduces the characteristics of prosthesis design, the advantages and disadvantages of prosthesis performance, as well as discusses the application principles of different types of prosthesis, their clinical consequences, and the tendency of knee prosthesis development.
引文
[1]Meftah M,White PB,Ranawat AS,et al.Long-term results of total157knee arthroplasty in young and active patients with posterior stabilized design[J].Knee,2006,23:318-321.
[2]Ranawat CS,Insall J,Shine J.Duo-condylar knee arthroplasty:hospital for special surgery design[J].Clin Orthop,1976,120:76-82.
[3]Laursen JO,Lind M.Treatment of full-thickness femoral cartilage lesions using condyle resurfacing prosthesis[J].Knee Surg Sports Traumatol Arthrosc,2017,3:746-751.
[4]Kozinn SC,Scott R.Unicondylar Knee Arthroplasty[J].J Bone Joint Surg Am,1989,1:145-150.
[5]Scott RD,Joyce MJ,Ewald FC,et al.McKeever metallic hemiarthroplasty of the knee in unicompartmental degenerative arthritis.long-term clinical follow-up and current indications[J].J Bone Joint Surg Am,1985,2:203-207.
[6]MacIntosh DL,Hunter GA.The use of the hemiarthroplasty prosthesis for advanced osteoarthritis and rheumatoid arthritis of the Knee[J].J Bone Joint Surg Br,1972,2:244-255.
[7]Price A,Allum R.Management of osteoarthritis of the knee[J].Ann R Coll Surg Engl,2010,6:459-462.
[8]Newman J,Pydisetty RV,Ackroyd C.Unicompartmental or total knee replacement:the 15-year results of a prospective randomised controlled trial[J].J Bone Joint Surg Br,2009,1:52-57.
[9]Mckeever DC.Patellar prosthesis[J].J Bone Joint Surg Am,1955,5:1074-1084.
[10]Duncan RC,Hay EM,Saklatvala J,et al.Prevalence of radiographic osteoarthritis-it all depends on your point of view[J].Rheumatology(Oxford),2006,6:757-760.
[11]van Jonbergen HP,Werkman DM,Barnaart LF,et al.Long-term outcomes of patellofemoral arthroplasty[J].J Arthroplasty,2010,7:1066-1071.
[12]Lonner JH.Patellofemoral arthroplasty:pros,cons,and design considerations[J].Clin Orthop,2004,428:158-165.
[13]Pagnano MW,Cushner FD,Scott WN.Role of the posterior cruciate ligament in total knee arthroplasty[J].J Am Acad Orthop Surg,1998,3:176-187.
[14]Mihalko WM,Miller C,Krackow KA.Total knee arthroplasty ligament balancing and gap kinematics with posterior cruciate ligament retention and sacrifice[J].Am J Orthop(Belle Mead NJ),2000,8:610-616.
[15]Becker R,Hirschmann MT,Karlsson J.The role of ligament tension and sensomotoric system in total knee arthroplasty[J].Knee Surg Sports Traumatol Arthrosc,2017,6:1663-1665.
[16]Harato K,Bourne RB,Victor J,et al.Midterm comparison of posterior cruciate-retaining versus-substituting total knee arthroplasty using the genesis II prosthesis.a multicenter prospective randomized clinical trial[J].Knee,2008,3:217-221.
[17]Swany MR,Scott RD.Posterior polyethylene wear in posterior cruciate ligament-retaining total knee arthroplasty.a case study[J].JArthroplasty,1993,4:439-446.
[18]Mahoney OM,Noble PC,Rhoads DD,et al.Posterior cruciate function following total knee arthroplasty.a biomechanical study[J].JArthroplasty,1994,6:569-578.
[19]Victor J,Banks S,Bellemans J.Kinematics of posterior cruciate ligament-retaining and-substituting total knee arthroplasty:a prospective randomised outcome study[J].J Bone Joint Surg Br,2005,5:646-655.
[20]Laskin RS.The Insall Award.Total knee replacement with posterior cruciate ligament retention in patients with a fixed varus deformity[J].Clin Orthop,1996,331:29-34.
[21]Ritter MA,Davis KE,Farris A,et al.The surgeon's role in relative success of PCL-retaining and PCL-substituting total knee arthroplasty[J].HSS J,2014,2:107-115.
[22]Puloski SK,McCalden RW,MacDonald SJ,et al.Tibial post wear in posterior stabilized total knee arthroplasty.an unrecognized source of polyethylene debris[J].J Bone Joint Surg Am,2001,3:390-397.
[23]Hozack WJ,Rothman RH,Booth RJ,et al.The patellar clunk syndrome.a complication of posterior stabilized total knee arthroplasty[J].Clin Orthop,1989,241:203-208.
[24]Mikashima Y,Tomatsu T,Horikoshi M,et al.In vivo deep-flexion kinematics in patients with posterior-cruciate retaining and anterior-cruciate substituting total knee arthroplasty[J].Clin Biomech(Bristol,Avon),2010,1:83-87.
[25]Luo CF.Reference axes for reconstruction of the knee[J].Knee,2004,4:251-257.
[26]Lozano-Calderon SA,Shen J,Doumato DF,et al.Cruciate-retaining vs posterior-substituting inserts in total knee arthroplasty:functional outcome comparison[J].J Arthroplasty,2013,2:234-242.
[27]Parks NL,Engh GA,Topoleski LD,et al.The Coventry award.modular tibial insert micromotion.a concern with contemporary knee implants[J].Clin Orthop,1998,356:10-15.
[28]Matsuda S,White SE,Williams VN,et al.Contact stress analysis in meniscal bearing total knee arthroplasty[J].J Arthroplasty,1998,6:699-706.
[29]Bhatt H,Rambani R,White W,et al.Primary total knee arthroplasty using the P.F.C sigma(R)-rotating platform cruciate retaining endoprosthesis-A 6 year follow Up[J].Knee,2012,6:856-859.
[30]Berry DJ,Currier JH,Mayor MB,et al.Knee wear measured in retrievals:a polished tray reduces insert wear[J].Clin Orthop,2012,7:1860-1868.
[31]Kim TW,Park SH,Suh JT.Comparison of mobile-bearing and fixed-bearing designs in high flexion total knee arthroplasty:using a navigation system[J].Knee Surg,2012,1:25-33.
[32]Jeon YS,Shin JS,Jung JH,et al.Total dnee arthroplasty using nexgen LPS-flex(R)improves clinical outcomes without early loosening:minimum 6-year follow-up results[J].J Orthop Surg Res,2016,1:83.
[33]Li C,Shen B,Yang J,et al.Do patients really gain outcome benefits when using the high-flex knee prostheses in total knee arthroplasty?a meta-analysis of randomized controlled trials[J].J Arthroplasty,2015,4:580-586.
[34]Chung SH,Jeon DG,Cho WH,et al.Temporary hemiarthroplasty with a synthetic device in children with osteosarcoma around the knee as a bridging procedure until skeletal maturity[J].J Surg Oncol,2015,1:107-114.
[35]Yang B,Yu JK,Zheng ZZ,et al.Comparative study of sex differences in distal femur morphology in osteoarthritic knees in a chinese population[J].PLoS One,2014,2:e89394.
[36]Thomsen MG,Husted H,Bencke J,et al.Do we need a genderspecific total knee replacement?a randomised controlled trial comparing a high-flex and a gender-specific posterior design[J].JBone Joint Surg Br,2012,6:787-792.
[37]吴东迎,袁峰,吴继彬,等.3D打印截骨导板在人工全膝关节置换术中的应用[J].中华骨科杂志,2015,9:921-926.
[38]Kwon OR,Kang KT,Son J,et al.Patient-specific instrumentation development in TKA:1stand 2Ndgeneration designs in comparison with conventional instrumentation[J].Arch Orthop Trauma Surg,2017,1:111-118.
[39]Kosse NM,Heesterbeek P,Schimmel J,et al.Stability and alignment do not Improve by using patient-specific instrumentation in total knee arthroplasty:a randomized controlled trial[J].Knee Surg Sports Traumatol Arthrosc,2017,1:29-35.
[40]杨荣利,徐万鹏,郭卫,等.特制半关节假体置换在儿童膝关节恶性骨肿瘤中的应用[J].中国骨肿瘤骨病,2005,01:1-4.
[41]Steinert AF,Sefrin L,Hoberg M,et al.Individualized total knee arthroplasty[J].Orthopade,2015,4:290-292,294-301.2018-04-11
[2]Ranawat CS,Insall J,Shine J.Duo-condylar knee arthroplasty:hospital for special surgery design[J].Clin Orthop,1976,120:76-82.
[3]Laursen JO,Lind M.Treatment of full-thickness femoral cartilage lesions using condyle resurfacing prosthesis[J].Knee Surg Sports Traumatol Arthrosc,2017,3:746-751.
[4]Kozinn SC,Scott R.Unicondylar Knee Arthroplasty[J].J Bone Joint Surg Am,1989,1:145-150.
[5]Scott RD,Joyce MJ,Ewald FC,et al.McKeever metallic hemiarthroplasty of the knee in unicompartmental degenerative arthritis.long-term clinical follow-up and current indications[J].J Bone Joint Surg Am,1985,2:203-207.
[6]MacIntosh DL,Hunter GA.The use of the hemiarthroplasty prosthesis for advanced osteoarthritis and rheumatoid arthritis of the Knee[J].J Bone Joint Surg Br,1972,2:244-255.
[7]Price A,Allum R.Management of osteoarthritis of the knee[J].Ann R Coll Surg Engl,2010,6:459-462.
[8]Newman J,Pydisetty RV,Ackroyd C.Unicompartmental or total knee replacement:the 15-year results of a prospective randomised controlled trial[J].J Bone Joint Surg Br,2009,1:52-57.
[9]Mckeever DC.Patellar prosthesis[J].J Bone Joint Surg Am,1955,5:1074-1084.
[10]Duncan RC,Hay EM,Saklatvala J,et al.Prevalence of radiographic osteoarthritis-it all depends on your point of view[J].Rheumatology(Oxford),2006,6:757-760.
[11]van Jonbergen HP,Werkman DM,Barnaart LF,et al.Long-term outcomes of patellofemoral arthroplasty[J].J Arthroplasty,2010,7:1066-1071.
[12]Lonner JH.Patellofemoral arthroplasty:pros,cons,and design considerations[J].Clin Orthop,2004,428:158-165.
[13]Pagnano MW,Cushner FD,Scott WN.Role of the posterior cruciate ligament in total knee arthroplasty[J].J Am Acad Orthop Surg,1998,3:176-187.
[14]Mihalko WM,Miller C,Krackow KA.Total knee arthroplasty ligament balancing and gap kinematics with posterior cruciate ligament retention and sacrifice[J].Am J Orthop(Belle Mead NJ),2000,8:610-616.
[15]Becker R,Hirschmann MT,Karlsson J.The role of ligament tension and sensomotoric system in total knee arthroplasty[J].Knee Surg Sports Traumatol Arthrosc,2017,6:1663-1665.
[16]Harato K,Bourne RB,Victor J,et al.Midterm comparison of posterior cruciate-retaining versus-substituting total knee arthroplasty using the genesis II prosthesis.a multicenter prospective randomized clinical trial[J].Knee,2008,3:217-221.
[17]Swany MR,Scott RD.Posterior polyethylene wear in posterior cruciate ligament-retaining total knee arthroplasty.a case study[J].JArthroplasty,1993,4:439-446.
[18]Mahoney OM,Noble PC,Rhoads DD,et al.Posterior cruciate function following total knee arthroplasty.a biomechanical study[J].JArthroplasty,1994,6:569-578.
[19]Victor J,Banks S,Bellemans J.Kinematics of posterior cruciate ligament-retaining and-substituting total knee arthroplasty:a prospective randomised outcome study[J].J Bone Joint Surg Br,2005,5:646-655.
[20]Laskin RS.The Insall Award.Total knee replacement with posterior cruciate ligament retention in patients with a fixed varus deformity[J].Clin Orthop,1996,331:29-34.
[21]Ritter MA,Davis KE,Farris A,et al.The surgeon's role in relative success of PCL-retaining and PCL-substituting total knee arthroplasty[J].HSS J,2014,2:107-115.
[22]Puloski SK,McCalden RW,MacDonald SJ,et al.Tibial post wear in posterior stabilized total knee arthroplasty.an unrecognized source of polyethylene debris[J].J Bone Joint Surg Am,2001,3:390-397.
[23]Hozack WJ,Rothman RH,Booth RJ,et al.The patellar clunk syndrome.a complication of posterior stabilized total knee arthroplasty[J].Clin Orthop,1989,241:203-208.
[24]Mikashima Y,Tomatsu T,Horikoshi M,et al.In vivo deep-flexion kinematics in patients with posterior-cruciate retaining and anterior-cruciate substituting total knee arthroplasty[J].Clin Biomech(Bristol,Avon),2010,1:83-87.
[25]Luo CF.Reference axes for reconstruction of the knee[J].Knee,2004,4:251-257.
[26]Lozano-Calderon SA,Shen J,Doumato DF,et al.Cruciate-retaining vs posterior-substituting inserts in total knee arthroplasty:functional outcome comparison[J].J Arthroplasty,2013,2:234-242.
[27]Parks NL,Engh GA,Topoleski LD,et al.The Coventry award.modular tibial insert micromotion.a concern with contemporary knee implants[J].Clin Orthop,1998,356:10-15.
[28]Matsuda S,White SE,Williams VN,et al.Contact stress analysis in meniscal bearing total knee arthroplasty[J].J Arthroplasty,1998,6:699-706.
[29]Bhatt H,Rambani R,White W,et al.Primary total knee arthroplasty using the P.F.C sigma(R)-rotating platform cruciate retaining endoprosthesis-A 6 year follow Up[J].Knee,2012,6:856-859.
[30]Berry DJ,Currier JH,Mayor MB,et al.Knee wear measured in retrievals:a polished tray reduces insert wear[J].Clin Orthop,2012,7:1860-1868.
[31]Kim TW,Park SH,Suh JT.Comparison of mobile-bearing and fixed-bearing designs in high flexion total knee arthroplasty:using a navigation system[J].Knee Surg,2012,1:25-33.
[32]Jeon YS,Shin JS,Jung JH,et al.Total dnee arthroplasty using nexgen LPS-flex(R)improves clinical outcomes without early loosening:minimum 6-year follow-up results[J].J Orthop Surg Res,2016,1:83.
[33]Li C,Shen B,Yang J,et al.Do patients really gain outcome benefits when using the high-flex knee prostheses in total knee arthroplasty?a meta-analysis of randomized controlled trials[J].J Arthroplasty,2015,4:580-586.
[34]Chung SH,Jeon DG,Cho WH,et al.Temporary hemiarthroplasty with a synthetic device in children with osteosarcoma around the knee as a bridging procedure until skeletal maturity[J].J Surg Oncol,2015,1:107-114.
[35]Yang B,Yu JK,Zheng ZZ,et al.Comparative study of sex differences in distal femur morphology in osteoarthritic knees in a chinese population[J].PLoS One,2014,2:e89394.
[36]Thomsen MG,Husted H,Bencke J,et al.Do we need a genderspecific total knee replacement?a randomised controlled trial comparing a high-flex and a gender-specific posterior design[J].JBone Joint Surg Br,2012,6:787-792.
[37]吴东迎,袁峰,吴继彬,等.3D打印截骨导板在人工全膝关节置换术中的应用[J].中华骨科杂志,2015,9:921-926.
[38]Kwon OR,Kang KT,Son J,et al.Patient-specific instrumentation development in TKA:1stand 2Ndgeneration designs in comparison with conventional instrumentation[J].Arch Orthop Trauma Surg,2017,1:111-118.
[39]Kosse NM,Heesterbeek P,Schimmel J,et al.Stability and alignment do not Improve by using patient-specific instrumentation in total knee arthroplasty:a randomized controlled trial[J].Knee Surg Sports Traumatol Arthrosc,2017,1:29-35.
[40]杨荣利,徐万鹏,郭卫,等.特制半关节假体置换在儿童膝关节恶性骨肿瘤中的应用[J].中国骨肿瘤骨病,2005,01:1-4.
[41]Steinert AF,Sefrin L,Hoberg M,et al.Individualized total knee arthroplasty[J].Orthopade,2015,4:290-292,294-301.2018-04-11