本文選題：關(guān)節(jié)成形術(shù) + 置換　； 參考：《中國組織工程研究》2015年39期

【摘要】：背景:后穩(wěn)定型膝關(guān)節(jié)假體股骨側(cè)需要額外的髁間截骨來容納脛骨柱和股骨窩結(jié)構(gòu),髁間窩兩側(cè)與股骨體相連處應(yīng)力集中是骨折好發(fā)部位。不同品牌假體不同型號間截骨量的差異并沒有具體數(shù)據(jù),不便于臨床醫(yī)生在選擇假體時(shí)參考。目的:比較臨床上常用的后穩(wěn)定型膝關(guān)節(jié)假體(進(jìn)口、國產(chǎn)的6個(gè)品牌)髁間截骨數(shù)據(jù)的不同,為臨床假體選擇和應(yīng)用提供依據(jù)。方法:選擇目前國內(nèi)常用的(進(jìn)口、國產(chǎn)的6個(gè)品牌)后穩(wěn)定型人工膝關(guān)節(jié)假體,包括Zimmer Nex Gen LPS、Stryker Scrorpio NRG Knee-Flexed、Depuy PFC Sigma、Smithnephew Genesis-2 PS、United-U1及威高GKPS。根據(jù)截骨模板確定截骨面包括股骨髁前截面、后截部、股骨髁遠(yuǎn)端截面、后斜截面;對應(yīng)股骨假體徑線包括髁內(nèi)外徑寬、髁前后徑寬、股骨髁間窩截骨寬度及深度,對上述數(shù)據(jù)進(jìn)行對比測量。結(jié)果與結(jié)論:6種膝關(guān)節(jié)股骨髁假體的前后徑/內(nèi)外徑、髁間窩截骨量及形態(tài)均存在差異,國外品牌股骨遠(yuǎn)端前后截骨面間徑線較短,對后髁的截骨程度較大。隨著應(yīng)用假體尺寸的增大,所用品牌髁間截骨寬度所致骨量丟失比例均呈下降趨勢,無論是小尺寸假體還是大尺寸假體,Stryker Scrorpio NRG Knee-Flexed假體髁間截骨寬度均較小。6個(gè)品牌的膝關(guān)節(jié)假體截骨尺寸有所不同,以上結(jié)果并不足以評價(jià)不同假體之間的優(yōu)劣,但就保留髁間骨儲量而言,髁間截骨量少的設(shè)計(jì)較具優(yōu)勢。
[Abstract]:Background: additional intercondylar osteotomy is needed to accommodate the tibial column and the femoral fossa structure on the femur side of the posterior stable knee prosthesis. The stress concentration on both sides of the intercondylar fossa is the most common site of fracture. There is no specific data on osteotomy volume between different models of prosthesis, which is not convenient for clinicians to refer to when selecting prosthesis. Objective: to compare the data of intercondylar osteotomy of posterior stable knee joint prosthesis (imported, 6 brands made in China), so as to provide evidence for selection and application of clinical prosthesis. Methods: Post-stable artificial knee prosthesis was selected, including Zimmer Nex Genesis-2 PSV United-U1, Zimmer Nex Gen LPS-Stryker Scrorpio NRG Knee-Flexedn Depuy PFC Sigma-Smithnephew Genesis-2 PSV United-U1. According to the osteotomy template, the osteotomy surface includes the anterior section of the femoral condyle, the posterior section of the femoral condyle, the distal section of the femoral condyle and the posterior oblique section. Compare and measure the above data. Results and conclusion there were differences in the anteroposterior / outer diameters of 6 kinds of femoral condylar prostheses, the amount and shape of intercondylar fossa osteotomy. The interfacial diameters of distal femur osteotomy in foreign brands were shorter, and the osteotomy degree of posterior condyle was higher. With the increase of the size of the prosthesis, the proportion of bone loss caused by the intercondylar osteotomy width of the brand decreased. The intercondylar osteotomy width of small size prosthesis or large size prosthesis is smaller. The above results are not enough to evaluate the advantages and disadvantages of different prostheses. However, in terms of reserve of intercondylar bone, the design with less intercondylar osteotomy is superior.
【作者單位】： 中山大學(xué)孫逸仙紀(jì)念醫(yī)院關(guān)節(jié)外科;中山大學(xué);
【基金】：廣東省科技計(jì)劃項(xiàng)目(2014A020215009)~~
【分類號】：R318.17

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