膝内侧间室骨关节炎单髁置换术有限元分析研究进展

Research progress on finite element analysis of unicompartmental knee arthroplasty in medial knee compartmental osteoarthritis

目的对近年膝内侧间室骨关节炎单髁置换术(unicompartmental knee arthroplasty,UKA)的有限元分析(finite element analysis,FEA)研究进展进行综述。方法查阅国内外有关膝内侧UKA的FEA研究文献,从假体排列和术后关节线对膝关节应力分布的影响以及假体改进、不同类型假体比较研究等方面进行归纳总结。结果目前,学者们对膝内侧间室骨关节炎UKA进行了大量FEA研究。研究结果显示,膝内侧固定平台假体UKA中,推荐胫骨假体冠状面排列为0°、后倾角为5°~7°;活动平台假体UKA中,胫骨假体冠状面排列为内翻4°~外翻4°、后倾角为5°~7°。股骨假体排列为股骨远端中心旋转中立位;关节线推荐为原关节线高度。解剖型假体UKA后膝关节生物力学接近正常。结论根据FEA研究力学分布结果可明确膝内侧UKA假体最佳排列和关节线,指导设计更适合患者的UKA假体。

Objective To review the research progress on finite element analysis(FEA) of unicompartmental knee arthroplasty(UKA) in medial knee compartmental osteoarthritis. Methods The FEA research literature on the medial knee UKA at home and abroad was reviewed, and the progress on the aspects of the influences of the prosthesis arrangement and the postoperative joint line on the mechanical distribution of the knee joint, the improvement of the UKA prosthesis, and the related research of different types of prostheses were summarized. Results At present, scholars have conducted a large number of FEA studies on UKA in the medial knee compartmental osteoarthritis. The results of the study show that the recommended coronal alignment and the tibial slope angle of tibial component in medial fixedbearing UKA are 0° and 5°-7°, respectively;and the coronal alignment and the tibial slope angle of tibial component in mobile-bearing UKA are 4° varus to 4° valgus and 5°-7°, respectively. The femoral component is arranged in the neutral position of the distal femur. The joint line is recommended to be the primary alignment. The anatomical UKA prosthesis can restore the biomechanical properties of the normal knee joint. Conclusion FEA research can clarify the best arrangement and joint line of the medial knee UKA prosthesis based on the mechanical distribution results, and guide the design of UKA prostheses that are more suitable for patients.