全膝关节置换术胫骨假体旋转定位研究进展

Research progress on rotation positioning of tibial component in total knee arthroplasty

全膝关节置换术(total knee arthroplasty,TKA)是治疗终末期骨性关节炎最有效措施之一,但胫骨假体的旋转对线不良可导致术后膝关节的长期慢性疼痛、胫股关节不稳定、假体无菌性松动、假体过度磨损,甚至关节脱位、垫片脱出等并发症。目前对于胫骨假体旋转定位参考轴以及胫骨假体位置的精准安放方法仍存在争议,本文将对胫骨假体旋转定位的主要方法及其研究进展作一综述,主要方法有髓内定位、髓外解剖标志定位、自我形合技术、计算机导航技术、个性化3D打印技术,以期为临床医生提供参考。

Total knee arthroplasty is one of the most effective measures for the treatment of end-stage osteoarthritis.However,poor rotation alignment of the tibial component will lead to long-term chronic pain of the knee joint after operation,instability of the tibiofemoral joint,aseptic loosening of the prosthesis,excessive abrasion of the prosthesis,and even joint dislocation and insert dislocation.At present there is still controversy about the precise placement method of the tibial component and its rotation alignment reference axis.This article reviews the main methods and research progress of the tibial component rotation positioning,involving intramedullary positioning and marrow external anatomical landmark positioning,self-alignment technology,computer navigation technology,and personalized 3 D printing technology,to provide a reference for clinicians.