摘要
目的 探讨人工全膝关节置换术（TKA）中截骨方法的研究进展。方法 在PubMed、Springer Link、FMJS、万方网络数据库中，以“膝关节置换术”、“截骨”、“计算机导航”和“个体化模板”为关键词，查阅1988年1月—2014年6月有关人工TKA中截骨技术研究的相关文献，进行分析和总结。结果 TKA是治疗中晚期膝关节疾病的标准经典手术，术中截骨方法主要有传统器械截骨、计算机导航及个体化模板辅助截骨等。TKA中传统器械截骨，依靠机械引导装置定位及术者经验截骨，主观性强，精确度较低，手术风险大，并发症多，手术效果欠佳。与传统器械截骨相比，计算机导航辅助截骨精度可能受多种因素影响，需要的时间和并发症发生的概率更多；另外，由于其学习曲线长、设备费用昂贵、技术要求高等众多因素，限制了导航系统的推广应用。个体化模板辅助TKA技术可设计精确化的截骨方法或工具，实现个体化解剖截骨，具有提高截骨精确性、缩短手术时间、减轻手术损伤等优势，膝关节术后功能恢复更加理想。结论 随着数字骨科的不断发展，人工TKA手术方案会更加个性化，截骨更精确。数字化、个体化截骨技术可能成为今后TKA发展的新方向。
Objective To evaluate the research progress of osteotomy technique in total knee arthroplasty （TKA）. Methods To analyze and summarize all the related literatures about the osteotomy technique in TKA by the key words of TKA, bone cutting, computer navigation and individual template in the database of PubMed, Springer Link, FMJS and Wanfang data from January 1988 to June 2014. Results TKA became standard classic surgery in the treatment of middle-late knee joint diseases, and the methods in the process of bone cutting included mainly traditional instruments, computer navigation and individual template. In traditional TKA, bone cutting was operated depending for mechanical guided localization and the experience of surgeons with a strong subjectivity, low precision, high risk and poor operative results. Compared with traditional operations, many factors affected the accuracy of bone cutting, consumed much time and higher complication rate in computer navigation assisted TKA. Besides, the long training time, the high expense of equipment and high technical requirement hmited the apphcation of the navigation system. The technology of individual template could design accurate cutting method or tool to realize individual operation for TKA. This method had advantages of improving accuracy, reducing the operation time and the surgical injury, and the post-operation recovery was good for the knee joint. Conclusions With the continuous development of digital orthopedics, TKA surgery scheme will be more personalized, more accurate bone cutting. Digital and individualized bone cutting technology will become the new direction of the development of the TKA in the future.
出处
《中华解剖与临床杂志》
2014年第6期515-518,共4页
Chinese Journal of Anatomy and Clinics
基金
国家自然科学基金资助项目（81171428）
