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三组件式全踝关节置换假体的设计及应用现状 被引量:1

Design and application status of three-component total ankle replacement prosthesis
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摘要 背景:早期的全踝关节置换假体,由于对踝关节生物力学的认识不足,较高的置入失败率和并发症发生率使得外科医生放弃了这种治疗方案。随着踝关节假体设计理念的不断更新,全踝关节置换越来越受到外科医生的青睐。目前,三组件式全踝关节置换假体被认为更符合正常踝关节生物力学的要求,并且被逐步推广应用于临床。目的:了解踝关节生物力学,总结3种三组件式全踝关节置换假体的设计特点,为进一步的假体设计总结经验。方法:由第一作者应用计算机检索CNKI、Pub Med等数据库建库至2020年2月有关全踝关节置换假体的文献,中文检索词为"全踝关节置换假体设计,STAR假体,HINTEGRA假体,BOX假体",英文检索词为"Total ankle replacement prosthesis design,STAR prosthesis,HINTEGRA prosthesis,BOX prosthesis"。结果与结论:(1)STAR假体、HINTEGRA假体、BOX假体在临床应用中表现出了可接受的生存率及临床结果,但仍然需要大量病例和长时间的随访进行验证;(2)3种全踝关节置换假体的设计都着重于恢复生理踝关节的解剖结构,再现踝关节的运动轴,兼容韧带的几何形状、减少踝关节周围组织的应力和机械对准;(3)要实现最大化的韧带兼容,假体组件的关节面设计必须是2个生理解剖形状或2个非生理解剖形状的关节面;(4)国人踝关节的形态和高加索人踝关节的形态有差异,期待设计研发符合国人踝关节要求的假体。 BACKGROUND:The early total ankle replacement has been abandoned for long times due to the insufficient understanding of the ankle joint biomechanics,higher implant failure rates and complications.With the updating of the design concept about ankle prosthesis,total ankle replacement surgery is now more and more popular among surgeons.At present,the three-component total ankle replacement prosthesis is considered to be more in line with the normal biomechanical requirements of the ankle joint,and has been gradually promoted for clinical application.OBJECTIVE:To understand the biomechanics of the ankle joint,summarize the design features of the three-component total ankle joint replacement prostheses,and summarize experience for further prosthetic design.METHODS:The first author used a computer to search CNKI and PubMed for the literature on total ankle replacement prostheses from inception to February 2020.The key words were"total ankle replacement prosthesis design,STAR prosthesis,HINTEGRA prosthesis,BOX prosthesis".RESULTS AND CONCLUSION:(1)The STAR,HINTEGRA,and BOX prostheses have shown acceptable survival rates and clinical results in clinical applications;however,a large number of cases and long-term follow-up were also required.(2)The designs of the three kinds of total ankle replacement prostheses all focus on restoring the anatomy of the physiological ankle joint,reproducing the axis of motion of the ankle joint,being compatible with the geometry of the ligament,and reducing the mechanical alignment of the tissue around the ankle joint.(3)To achieve maximum ligament compatibility,the articular surface design of the prosthetic component must be two physiological anatomic shapes or two non-physiological anatomic shapes.(4)There is a significant difference between the shape of the Chinese ankle and that of Caucasian.We are looking forward to design and develop a more suitable prosthesis for Chinese peoples.
作者 王松波 凌鸣 王继成 刘时璋 Wang Songbo;Ling Ming;Wang Jicheng;Liu Shizhang(Xi'an Medical University,Xi'an 710068,Shaanxi Province,China;Orthopedic Hospital of Shaanxi Provincial People's Hospital,Xi'an 710068,Shaanxi Province,China)
出处 《中国组织工程研究》 CAS 北大核心 2020年第30期4847-4853,共7页 Chinese Journal of Tissue Engineering Research
基金 陕西省重点研发计划项目(2018ZDXM-SF-057),项目名称:扩大椎板切除对脊髓短缩性损伤的作用研究,项目负责人:刘时璋。
关键词 关节 假体 力学 全踝关节置换 STAR假体 HINTEGRA假体 BOX假体 三组件式 joint prosthesis mechanics total ankle replacement STAR prosthesis HINTEGRA prosthesis BOX prosthesis three-component
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