目的:探讨计算机导航间隙平衡技术对全膝关节置换术患者术后下肢功能恢复的影响。方法:回顾性分析2018年7月至2019年6月接受全膝关节置换术的106例膝关节骨性关节炎(osteoarthritis,OA)患者的临床资料,根据全膝关节置换术中截骨技术不...目的:探讨计算机导航间隙平衡技术对全膝关节置换术患者术后下肢功能恢复的影响。方法:回顾性分析2018年7月至2019年6月接受全膝关节置换术的106例膝关节骨性关节炎(osteoarthritis,OA)患者的临床资料,根据全膝关节置换术中截骨技术不同分为测量截骨组和间隙平衡组。测量截骨组61例,男24例,女37例;年龄45~77(63.35±4.26)岁;K-L分级,Ⅲ级41例,Ⅳ级20例,术中实施测量截骨技术。间隙平衡组45例,男17例,女28例;年龄45~78(64.03±4.31)岁;K-L分级,Ⅲ级29例,Ⅳ级16例,实施计算机导航间隙平衡技术。比较两组患者术中出血量、手术时间、切口长度、住院时间及术后并发症情况,分别于术前、术后12个月采用膝关节协会评分(Knee Society Knee Score,KSS)评价其临床疗效。结果:106例患者均获得随访,时间12~18(20.38±3.25)个月。两组术中出血量、手术时间分比较差异有统计学意义(P<0.05)。两组切口长度和住院时间比较差异无统计学意义(P>0.05)。术后12个月,间隙平衡组KSS总分(173.59±14.50)分优于测量截骨组(164.95±12.10)分(P<0.05)。两组患者随访期间未发生假体松动不良严重并发症,其他并发症发生率组间比较差异无统计学意义(P>0.05)。结论:全膝关节置换术中应用计算机导航间隙平衡技术利于OA患者术后下肢功能恢复,且术后未发生严重不良并发症,安全性高。展开更多
Objective: To observe the accuracy of femoral preparation and the position of the cementless prosthesis in femoral cavity, and to compare the results between the computer-assisted surgical group (CASPAR) and the conve...Objective: To observe the accuracy of femoral preparation and the position of the cementless prosthesis in femoral cavity, and to compare the results between the computer-assisted surgical group (CASPAR) and the conventional group. Methods: Ten femoral components were implanted either manually or by CASPAR in cadaver femurs. The specimens were cut to 3mm thick slices. Microradiograms of every slice were sent to a computer for analysis with special software (IDL). The gaps and the medullary cavities between component and bone, the direct bone contact area of the implant surface, the gap width and the percentage of gap and bone contact area were measured in every slice. Results: In the proximal implant coated with HA of the CASPAR group, the average percentage of bone contact reached 93.2% (ranging from 87.6% to 99.7%); the average gap percentage was 2.9% (ranging from 0.3% to 7.8%); the maximum gap width was 0.81mm and the average gap width was only 0.20mm. While in the conventional group, the average percentage of bone contact reached 60.1% (ranging from 49.2% to 70.4%); the average gap percentage was 32.8% (ranging from 25.1% to 39.9%); the maximum gap width was 2.97mm and the average gap width was 0.77mm. The average gap around the implant in the CASPAR group was only 9% of that in the manual group; the maximum and average gap widths were only about 26% of those in the manual group. On the other hand, the CASPAR group showed 33% higher bone contact than the manual group. Conclusion: With the use of robotics-assisted system, significant progress can be achieved for femoral preparation in total hip arthroplasty.展开更多
Metallic implants are commonly used in various orthopaedic surgeries, like fracture fixation, spinal instrumentation, joint replacement and bone tumour surgery.Patients may need to adapt to the fixed dimensions of the...Metallic implants are commonly used in various orthopaedic surgeries, like fracture fixation, spinal instrumentation, joint replacement and bone tumour surgery.Patients may need to adapt to the fixed dimensions of the standard implants. It may result in suboptimal fit to the host bones and possible adverse clinical results. The standard traditional implants may not address the reconstructive challenges such as severe bone deformity or bone loss after implant loosening and bone tumour resection. With the advent of digital technologies in medical imaging, computer programming in three-dimensional（3 D） modelling and computer-assisted tools in precise placement of implants, patient-specific implants（PSI） have gained more attention in complex orthopaedic reconstruction. Additive manufacturing technology, in contrast to the conventional subtractive manufacturing, is a flexible process that can fabricate anatomically conforming implants that match the patients’ anatomy and surgical requirements. Complex internal structures with porous scaffold can also be built to enhance osseointegration for better implant longevity. Although basic studies have suggested that additive manufactured（AM） metal structures are good engineered biomaterials for bone replacement, not much peer-reviewed literature is available on the clinical results of the new types of implants. The article gives an overview of the metallic materials commonly used for fabricating orthopaedic implants, describes the metal-based additive manufacturing technology and the processing chain in metallic implants; discusses the features of AM implants;reports the current status in orthopaedic surgical applications and comments on the challenges of AM implants in orthopaedic practice.展开更多
文摘目的:探讨计算机导航间隙平衡技术对全膝关节置换术患者术后下肢功能恢复的影响。方法:回顾性分析2018年7月至2019年6月接受全膝关节置换术的106例膝关节骨性关节炎(osteoarthritis,OA)患者的临床资料,根据全膝关节置换术中截骨技术不同分为测量截骨组和间隙平衡组。测量截骨组61例,男24例,女37例;年龄45~77(63.35±4.26)岁;K-L分级,Ⅲ级41例,Ⅳ级20例,术中实施测量截骨技术。间隙平衡组45例,男17例,女28例;年龄45~78(64.03±4.31)岁;K-L分级,Ⅲ级29例,Ⅳ级16例,实施计算机导航间隙平衡技术。比较两组患者术中出血量、手术时间、切口长度、住院时间及术后并发症情况,分别于术前、术后12个月采用膝关节协会评分(Knee Society Knee Score,KSS)评价其临床疗效。结果:106例患者均获得随访,时间12~18(20.38±3.25)个月。两组术中出血量、手术时间分比较差异有统计学意义(P<0.05)。两组切口长度和住院时间比较差异无统计学意义(P>0.05)。术后12个月,间隙平衡组KSS总分(173.59±14.50)分优于测量截骨组(164.95±12.10)分(P<0.05)。两组患者随访期间未发生假体松动不良严重并发症,其他并发症发生率组间比较差异无统计学意义(P>0.05)。结论:全膝关节置换术中应用计算机导航间隙平衡技术利于OA患者术后下肢功能恢复,且术后未发生严重不良并发症,安全性高。
文摘Objective: To observe the accuracy of femoral preparation and the position of the cementless prosthesis in femoral cavity, and to compare the results between the computer-assisted surgical group (CASPAR) and the conventional group. Methods: Ten femoral components were implanted either manually or by CASPAR in cadaver femurs. The specimens were cut to 3mm thick slices. Microradiograms of every slice were sent to a computer for analysis with special software (IDL). The gaps and the medullary cavities between component and bone, the direct bone contact area of the implant surface, the gap width and the percentage of gap and bone contact area were measured in every slice. Results: In the proximal implant coated with HA of the CASPAR group, the average percentage of bone contact reached 93.2% (ranging from 87.6% to 99.7%); the average gap percentage was 2.9% (ranging from 0.3% to 7.8%); the maximum gap width was 0.81mm and the average gap width was only 0.20mm. While in the conventional group, the average percentage of bone contact reached 60.1% (ranging from 49.2% to 70.4%); the average gap percentage was 32.8% (ranging from 25.1% to 39.9%); the maximum gap width was 2.97mm and the average gap width was 0.77mm. The average gap around the implant in the CASPAR group was only 9% of that in the manual group; the maximum and average gap widths were only about 26% of those in the manual group. On the other hand, the CASPAR group showed 33% higher bone contact than the manual group. Conclusion: With the use of robotics-assisted system, significant progress can be achieved for femoral preparation in total hip arthroplasty.
文摘Metallic implants are commonly used in various orthopaedic surgeries, like fracture fixation, spinal instrumentation, joint replacement and bone tumour surgery.Patients may need to adapt to the fixed dimensions of the standard implants. It may result in suboptimal fit to the host bones and possible adverse clinical results. The standard traditional implants may not address the reconstructive challenges such as severe bone deformity or bone loss after implant loosening and bone tumour resection. With the advent of digital technologies in medical imaging, computer programming in three-dimensional（3 D） modelling and computer-assisted tools in precise placement of implants, patient-specific implants（PSI） have gained more attention in complex orthopaedic reconstruction. Additive manufacturing technology, in contrast to the conventional subtractive manufacturing, is a flexible process that can fabricate anatomically conforming implants that match the patients’ anatomy and surgical requirements. Complex internal structures with porous scaffold can also be built to enhance osseointegration for better implant longevity. Although basic studies have suggested that additive manufactured（AM） metal structures are good engineered biomaterials for bone replacement, not much peer-reviewed literature is available on the clinical results of the new types of implants. The article gives an overview of the metallic materials commonly used for fabricating orthopaedic implants, describes the metal-based additive manufacturing technology and the processing chain in metallic implants; discusses the features of AM implants;reports the current status in orthopaedic surgical applications and comments on the challenges of AM implants in orthopaedic practice.
