全膝关节置换术对线理念的研究现状

Current research on alignment concepts in total knee arthroplasty

近年来随着膝骨性关节炎患病率的增加,全膝关节置换术作为治疗终末期骨性关节炎的最有效方式之一,变得越来越普遍。传统上认为,恢复下肢机械力学对线是全膝关节置换术的主要目标之一,因为其对假体的长期生存率至关重要,长期随访研究也证实了该理念的可靠性。然而,与全髋关节置换术相比,全膝关节置换患者术后的功能及满意度均不高。尽管随着科技的进步,膝关节假体设计及手术技术都有了较大的进步,但是仍有将近20%的患者对自己的手术表示不满意。在此基础上,许多骨科医生开始对传统中性机械对线理念提出质疑,并提出了多种新的对线理念。本文旨在对目前不同全膝关节置换对线理念作一综述。

The prevalence of knee joint osteoarthritis(OA)is increasing in recent years,while the total knee arthroplasty(TKA),which has been approved to be one of the most successful procedures for end-stage OA,becomes popular more and more.Restoring neutral mechanical alignment of lower limbs has long been regarded as one of the major goals of TKA,because it plays a fundamental role in the longterm survivorship of knee prosthesis,which also has been demonstrated by many long-term follow-up studies.However,the patients remain far from satisfaction to TKA in term of postoperative function in comparison with total hip arthroplasty(THA).Despite of the fact that development in technology and materials had improved the prosthetic design and surgical techniques considerably,up to 20%patients were not satisfied to their surgical intervention.Consequently,orthopedists began to wonder whether the traditional alignment is valid,and proposed a variety of new alignment concepts.This article aims to provide a comprehensive review of current TKA alignment options.