摘要
牛津单髁置换术后胫骨假体位置至关重要,其中胫骨假体的覆盖情况就是影响手术效果的因素之一。假体的探出可能造成内侧副韧带的受损以及周围软组织激惹,而覆盖不足因缺乏内侧骨皮质的支撑作用,容易出现假体下沉、松动等并发症,对手术效果和患者术后功能造成不良影响。另一方面,胫骨假体的旋转也已被证实与患者术后功能相关。从手术角度来看,胫骨垂直截骨是影响胫骨假体放置的决定性因素,从而影响胫骨假体的覆盖和旋转。在既往研究以及实际临床工作中不难发现,按照牛津标准垂直截骨方向和位置,部分患者胫骨假体并不能达到完美覆盖,且不同患者间胫骨假体旋转也存在较大差异。探究牛津标准垂直截骨对胫骨假体覆盖与旋转产生如何影响,以及是否存在更合理的胫骨垂直截骨方向及位置,可以为术者追求更好的牛津单髁置换手术效果起到积极的指导作用。
The placement of the tibial component is critical on the effect of Oxford mobile-bearing unicompartmental knee arthroplasty(OUKA).On the one hand,the coverage of tibial component is one of the factors affecting the clinical outcome.Overhang of tibial component can cause the damage to the medial collateral ligament and irritate the surrounding soft tissue,while underhang may easily lead to some complications such as subsidence and loosening of tibial component due to the lack of the support of the medial cortex.Both of them cause an adverse effect on the clinical result and postoperative function of the patients.Rotation of the tibial component has also been shown to associate with postoperative function in patients.From the perspective of surgery,the vertical cut on the tibial plateau is the decisive procedure affecting the placement of the tibial component,thus affecting the coverage and rotation of the tibial component.In previous studies and the clinical practices,it is found that,according to the direction and position of the standard vertical cut by Oxford,the tibial component of some patients could not cover perfectly,and the rotations of the tibial component are various.The investigation of the influence of Oxford standard vertical cut on the coverage and rotation of the tibial component,and whether there is a relationship between the coverage and rotation of the tibial component,may play a positive role in guiding surgeons to get better results of Oxford mobile-bearing unicompartmental knee arthroplasty.
作者
高广涵
曹光磊
Gao Guanghan;Cao Guanglei(Department of Orthopaedics,Xuanwu Hospital Capital Medical University,Beijing 100053,China)
出处
《中华关节外科杂志（电子版）》
CAS
CSCD
2019年第6期745-749,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
首都卫生发展科研专项基金(首发2018-2-2012)
关键词
关节成形术
置换
膝
旋转
胫骨
Arthroplasty
replacement
knee
Rotation
Tibia
