人工髋关节未来10年发展设想
인공관관절미래10년발전설상
Development of total hip replacements in the coming 10 years
  • 万方数据
    中国临床康复 중국림상강복
    CHINESE JOURNAL OF CLINICAL REHABILITATION
    2006年 41期 225-228 ,共4页

    张汉庆%甘宁%陈选宁

    장한경%감저%진선저

    组织工程%置换%髋/方法%髋假体%机器人%外科手术%综述文献 組織工程%置換%髖/方法%髖假體%機器人%外科手術%綜述文獻
    조직공정%치환%관/방법%관가체%궤기인%외과수술%종술문헌
    目的:人工髋关节研究一直是近年热点,自运用以来在临床方面取得了可喜的成果,但由于自身材料和技术问题使远期效果受到一定的限制.本文就人工髋关节未来十年的发展趋势和临床应用前景进行综述.资料来源:应用计算机检索PUBMED 1990-01/2006-01期间的相关文章,检索词为"total hip replacements,surgical robot,tissue engineering,virtual endoscopy",并限定文章语言种类为English.同时计算机检索万方数据库1990-01/2005-12期间的相关文章,检索词为"人工髋关节,材料,仿真内镜,手术机器人,组织工程学",并限定文章语言种类为中文.资料选择:对资料进行初审,并查看每篇文献后的引文.纳入标准:文章所述内容应与人工髋关节研究相关.排除标准:重复研究或Meta分析类文章.资料提炼:共收集到39篇相关文献,22篇文献符合纳入标准,排除的17篇文献为内容陈旧或重复.符合纳入标准的22篇文献中,5篇涉及人工关节材料对假体松动和致癌性的影响,2篇涉及计算机辅助导航手术使人工关节手术微创化,1篇涉及机器人引入人工关节手术,3篇涉及定制和特制人工关节的发展,9篇涉及人工髋关节表面置换的可能性,2篇涉及组织工程技术与人工关节的结合.资料综合:现代人工髋关节研究探索新的耐磨损假体,减少骨溶解、骨吸收所致的假体松动.根据病情的需要利用计算机辅助设计/制造技术进行特殊设计和制作,解决假体周围骨折及肿瘤保肢手术的要求.计算机辅助导航手术使人工关节手术微创化,术后患者恢复快.通过开发具有中国本土化的手术机器人,提高人工髋关节手术的成功率.运用仿真关节镜,能够准确了解关节内软骨及软骨下骨破坏情况,并将其量化,可以选择最为合适可靠的假体,增加精确性.组织工程技术修复缺损能够提高假体骨性结合,使人工关节置换技术更加完美.结论:未来十年人工髋关节将向着求稳定、零危害、微创化、机械化、个体化、多样化发展,从而使人工髋关节置换技术更加规范、安全和高成功率.
    목적:인공관관절연구일직시근년열점,자운용이래재림상방면취득료가희적성과,단유우자신재료화기술문제사원기효과수도일정적한제.본문취인공관관절미래십년적발전추세화림상응용전경진행종술.자료래원:응용계산궤검색PUBMED 1990-01/2006-01기간적상관문장,검색사위"total hip replacements,surgical robot,tissue engineering,virtual endoscopy",병한정문장어언충류위English.동시계산궤검색만방수거고1990-01/2005-12기간적상관문장,검색사위"인공관관절,재료,방진내경,수술궤기인,조직공정학",병한정문장어언충류위중문.자료선택:대자료진행초심,병사간매편문헌후적인문.납입표준:문장소술내용응여인공관관절연구상관.배제표준:중복연구혹Meta분석류문장.자료제련:공수집도39편상관문헌,22편문헌부합납입표준,배제적17편문헌위내용진구혹중복.부합납입표준적22편문헌중,5편섭급인공관절재료대가체송동화치암성적영향,2편섭급계산궤보조도항수술사인공관절수술미창화,1편섭급궤기인인입인공관절수술,3편섭급정제화특제인공관절적발전,9편섭급인공관관절표면치환적가능성,2편섭급조직공정기술여인공관절적결합.자료종합:현대인공관관절연구탐색신적내마손가체,감소골용해、골흡수소치적가체송동.근거병정적수요이용계산궤보조설계/제조기술진행특수설계화제작,해결가체주위골절급종류보지수술적요구.계산궤보조도항수술사인공관절수술미창화,술후환자회복쾌.통과개발구유중국본토화적수술궤기인,제고인공관관절수술적성공솔.운용방진관절경,능구준학료해관절내연골급연골하골파배정황,병장기양화,가이선택최위합괄가고적가체,증가정학성.조직공정기술수복결손능구제고가체골성결합,사인공관절치환기술경가완미.결론:미래십년인공관관절장향착구은정、령위해、미창화、궤계화、개체화、다양화발전,종이사인공관관절치환기술경가규범、안전화고성공솔.
    OBJECTIVE: Researches on total hip replacements are always the hot spots in recent years. The replacements have obtained satisfactory outcomes in clinic. However, the long-term effect is limited because of the material and technical problems. This paper is to summarize the developmental trend and the prospect of clinical application for total hip replacements in 10 years.DATA SOURCES: A computer-based online search of Medline database was undertaken to identify relevant articles published in English from January 1996 to January 2006 by using the keywords of "total hip replacements, surgical robot, tissue engineering, virtual endoscopy". Meanwhile,Chinese relevant articles published from January 1990 to December 2005 were searched in Wanfang database, the keywords were "total hip replacements, material, virtual endoscopy, surgical robot, tissue engineering" in Chinese.STUDY SELECTION: The articles were primarily checked, and the references in each literature were reviewed. Articles about the study on total hip replacements were involved; Meanwhile, the repetitive studies or Meta analysis were excluded.DATA EXTRACTION: Totally 39 relevant articles were collected, and 22 of them accorded with the. Inclusive criteria, 17 old or repetitive ones were excluded. Of the 22 articles, 5 were about the influence of artificial joint material on prosthetic loosening and its carcinogenesis; 2 about the microinvasion of joint replacement induced by computer-aided surgery navigation; 1 about the introduction of surgical robot; 3 about the development of custom-made and specially made artificial joint; 9 about the possibility for the surface replacement of hip; and 2 about the combination of tissue engineering technique and artificial joint.DATA SYNTHESIS: Modern researches on total hip replacements are exploring wearing tolerant prosthesis to reduce the prosthetic loosening caused by osteolysis and bone resorption. The computer-aided design/made technique is used for special design and manufacture according to the need of disease, so as to solve the fracture around prosthesis and meet the need of limb salvage surgery. The computer-aided surgery navigation realizes the microinvasion of joint replacement and the fast recovery after surgery. The successful rate of total hip replacements is improved by developing localized surgical robot in China. By using the virtual endoscopy, we can accurately know the damaged conditions of intraarticular cartilage and sub-cartilage bone, which are also able to be quantifized, so that more suitable and reliable prosthesis can be selected to increase the accuracy. The tissue engineering technique in repairing defect can increase the synostosis of prosthesis, and perfect the technique of joint replacement.CONCLUSION: In the coming 10 years, total hip replacements will develop towards stability, harmlessness, microinvasion, mechanization, individualization and diversification, so that the total hip replacements will be much stander and safer with higher successful rate.
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