保留前后交叉韧带的全膝关节置换研究进展

Research progress in bicruciate-retaining total knee arthroplasty

全膝关节置换术作为终末期骨性关节炎的重要手术方法取得了很好的长期效果以及假体生存率。目前临床上常用的膝关节假体以后交叉韧带保留型(cruciate retaining, CR)以及后稳定型(posterior stabilized, PS)为主。无论是后交叉韧带保留型还是后稳定型假体,在置入时都需切除前交叉韧带。前交叉韧带是膝关节本体感受器的重要存在部位,前交叉韧带的切除会造成膝关节的本体感觉以及运动力学的改变,使得患者的主观感受不是特别满意。作为能最大程度模拟自然膝关节运动力学的保留前后交叉韧带型(bicruciate-retaining, BCR)假体,最近重新引起人们的关注。

Total knee replacement(TKA), an important surgical technique for end-stage osteoarthritis, has achieved good long-term results and prosthesis survival rate. Currently, cruciate retaining(CR) and posterior stabilized(PS) prostheses are the main types of TKA commonly used in clinical practice. However, the anterior cruciate ligament(ACL) must be removed during the implantation of both CR and PS prostheses in TKA. ACL is an important location of knee proprioception receptors. The removal of ACL will lead to changes in knee proprioception and motion mechanics, cause the subjective feelings inefficient. The bicruciate-retaining(BCR) knee can best simulate natural knee motion mechanics, has attracted renewed attention recently.