全膝关节置换假体类型及应用进展

Types and Application Progress of Prosthesis in Total Knee Arthroplasty

全膝关节置换术是终末期膝关节骨性关节炎的主要治疗方法,目前应用于初次膝关节置换的假体类型主要有3种,根据设计结构可分为后交叉韧带保留型(CR)、后稳定型(PS)以及超形合度型(UC)。其中,CR与PS是应用时间较久的两种假体,治疗效果良好,但也存在缺点。UC是一种新型假体,具有能降低手术难度、减少磨损以及保留骨量等优点,虽然其在术中活动度、股骨后滚及稳定性上低于PS假体,但从术后随访的各项评分中可以看出,短中期内UC假体与CR和PS假体治疗效果相似。目前关于UC假体的术后长期随访报道较少,其术后远期的功能表现仍需进一步探究。

Total knee arthroplasty is the main treatment method for end-stage osteoarthritis.At present,there are three types of prostheses used in primary knee arthroplasty.According to the different designs,they can be divided into cruciate retaining insert(CR),posterior-stabilized insert(PS)and ultra-congruent insert(UC).CR and PS are two kinds prostheses used for a long time and they can achieve good therapeutic effect,but they both have disadvantages.UC is a new type of prosthesis design,which can reduce the operation difficulty,decrease wear and tear,and retain bone mass.Although its performance in intraoperative range of motion,femur roll-back and stability is under PS,it can be seen in the postoperative follow-up that UC insert can achieve the same good therapeutic effect as the CR and PS insert in the short and medium term.At present,there are few long-term follow-up reports on UC,and the long-term postoperative functional performance still needs further observation.