人工膝关节置换术的演变及其最优选择

The Philosophy-thinkings about Total Knee Prosthesis replacement of Development

人工关节是指用生物相容性与机械性能良好的金属材料制成的一种类似人体骨关节的假体。近年的关节外科发展迅速,人工膝关节置换术每年都在改进,治疗效果已有明显的进步,各种形式的假体不断推出。随着生物医学模式向生物—心理—社会医学模式的转变,患者日益要求人工关节质量好、费用少、与术后生活质量并举。回顾膝关节假体发展的历史,剖析其各阶段的重大变革,骨科专业医务工作者从以下几个方面进行哲学思考:(1)人类对人工膝关节置换的认识受到主客观条件的限制,经过多次往复才得以完成到目前水平;(2)人工膝关节置换选择中既要理解它的共性原则,更要把握它的个性原则,才能达到人工与自然的协调;(3)最优化是人工膝关节置换发展中的最终目标。

Artificial joint is a kind of prosthesis similar to the hone-joint of human body, which is made of metallic materials with good biocompatibitity and mechanical function. Joint - surgery has been developing quickly nowadays, Total knee prosthesis replacement upgrades year by year and the therapeutic effects have already made conspicuous improvements. All kinds of prostheses appear endlessly. Along with the biomedical model transforming to the biont- psych-social medical model, the patients are increasingly requesting artificial joints with high - quality, low- cost and getting fine postop quality of life simultaneously. Looking back to the developmental history of knee joints prosthesis, analyzing its grave reforming in each stage, medical workers majoring in orthopedics should think a lot philosophically as following： （ 1）The recognition of mankind in total knee prosthesis is limited to subjective and objective conditions, we need reciprocating cognition to reach the existing level. （2）We must know not only the oommon principles but also the individual principals in the choices of total knee prosthesis replacements in order to reach the harmony between people and nature. （3）Optimizing is the extreme target in the development of the total knee prosthesis.