三代Oxford单髁置换动静态定位技术减少垫片脱位的临床经验性回顾研究

A new static combined dynamic technique for femoral component positioning in meniscal bearing unicompartmental arthroplasty of third generation Oxford knee

目的介绍第三代Oxford半月板单髁股骨假体的动、静态定位技术,以期获得良好的半月板垫片运动轨迹,减少旋转,从而减少半月板垫片因过度旋转而脱位的并发症。方法采用动态标记加器械静态定位,确定股骨假体的位置,观察试模垫片的轨迹,再次调整假体的方位,最终获得良好的半月板垫片轨迹。跟踪随访采用该项技术术后1年以上的65膝,观察垫片脱位发生率。结果未发生一例半月板垫片脱位。结论动静态结合,试模轨迹测试股骨假体定位技术,可显著减少活动半月板垫片脱位的发生率。

Objective To introduce a our new static combined dynamic technique for femoral component positioning in meniscal bearing unicompartmental arthroplasty of third generation Oxford knee. New technique was postulated to gain a simple antero-posterior tracking which meniscal bearing went in and minimize bearing rotation thereafter dislocation which resulted from over-rotation of meniscal bearing. Methods The femoral component in Oxford UKA was positioned not only with cutting guide at femoral distal but also referenced to a central line which was marked in a dynamic manner.Moreover, femoral component was finally checked and minimally adjusted according to tracking of meniscal bearing trail until an antero-posterior tracking with minimal rotation was obtained. 65 knees were replaced with Oxford UKA with technique above and carefully followed up more than 1 year and complications, especially bearing dislocation were recorded. Results The meniscal bearing dislocation in this group had none of all one year postoperatively. Conclusion The static combined dynamic technique, which is to determine the position and orientation of femoral component, may decrease the dislocation rate of meniscal bearing significantly in Oxford UKA.