郭盛杰;唐浩;蒋毅;杨德金;周一新;

• 1:北京积水潭医院矫形骨科

摘要(Abstract)：

[目的]比较不同后倾及不对称后倾的聚乙烯垫片对于后交叉保留型全膝关节置换(CR-TKA)术关节内应力分布的影响。[方法]2016年1月~2017年8月在本中心行全膝关节置换患者共40例(40膝)纳入本研究,其中男性16例,女性24例。根据Vanguard CR-TKA垫片的标准型(CR-TKA-SI)的外侧半与厚唇型(CR-TKA-LI)的内侧半,设计后倾不对称型聚乙烯垫片(CR-TKA-APSI)并制作三种垫片的智能试模,使用膝关节置换术中无线应力检测系统(WFMS)分别测量三种不同形态的垫片放入后膝关节内外侧间室的应力分布情况。[结果]术中关节内总应力分布:三种形态的垫片关节内总应力屈曲过程中均逐渐减小,0°~45°时三组间总应力差异无统计学意义(P>0.017),60°~120°时CR-TKA-LI组的关节内总应力显著高于CR-TKA-SI组与CR-TKA-APSI组(P<0.017)。术中关节内外侧间室应力分布:0°~45°三组间内侧间室占总应力比例无显著差异,屈曲60°~120°时CR-TKA-APSI组内侧间室应力占总应力百分比为41.68%~66.82%,显著高于CR-TKA-SI与CR-TKA-LI组。[结论]内外侧后倾角相同的垫片,在整体后倾角改变时,可以调整CR型全膝关节屈曲位的软组织总体张力情况,但不会显著改变内外侧关节应力分布比例;而内外侧不对称后倾的垫片可起到调节屈曲位关节内应力分布的作用。

关键词(KeyWords)： 全膝关节置换术;垫片;后倾角;应力分布;内外翻应力试验法

Abstract:

Keywords:

基金项目(Foundation): 北京市科技计划-首都临床特色应用研究与成果推广课题(编号:Z151100004015145)

作者(Author): 郭盛杰;唐浩;蒋毅;杨德金;周一新;

Email:

DOI:

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