非骨水泥型膝关节假体的临床应用进展

Clinical application progress of cementless fixation component for total knee arthroplasty

骨水泥固定型假体广泛应用于全膝关节置换术(total knee arthroplasty,TKA),被称为TKA的"金标准",约占所有TKA的95.2%;而在19世纪80年代兴起的非骨水泥型膝关节假体因较高的早期失败率应用受到很大限制。如今,随着假体材料、制作工艺的进步与革新及患者年轻化,非骨水泥型膝关节假体再次成为热点。常见的非骨水泥型假体包括羟基磷灰石生物活性涂层、钛涂层和多孔钽金属骨小梁假体等,均获得较好的临床随访结果,并依靠骨长入生物固定理念获得更低的无菌性松动率和较高的假体长期生存率,更适合于活动量较大的年轻患者。本文就非骨水泥型假体的特点及临床应用等问题进行综述。

Cemented fixation prosthesis has been widely used in total knee arthroplasty（TKA）, which accounts for 95.2% of all TKAs, regarded as the gold standard of TKA. While cementless fixation prosthesis emerged in the 1880s was severely restricted due to the high early failure rate in TKA. However, with the advances in prosthesis material and manufacture procedure and age of patients undergoing TKA becoming younger, cementless fixation prosthesis has been concerned again for its good clinical outcome, lower aseptic loosening rate and higher long-term survival rate of prosthesis based on bone ingrowth idea, including hydroxyapatite-coated, highly porous titanium-coated and trabecular metal prostheses, which is more suitable for younger patients with more physical activities. In this paper, we reviewed the characteristics and clinical application of cementless fixation component for TKA.