中华解剖与临床杂志
中華解剖與臨床雜誌
중화해부여림상잡지
Chinese Journal of Anatomy and Clinics
2014年
6期
515-518
,共4页
关节成形术,置换,膝%截骨术%下肢力线%外科手术,计算机辅助%个体化模板
關節成形術,置換,膝%截骨術%下肢力線%外科手術,計算機輔助%箇體化模闆
관절성형술,치환,슬%절골술%하지력선%외과수술,계산궤보조%개체화모판
Arthroplasty,replacement,knee%Osteotmy%Limb alignment%Surgery,computer-assisted%Individual template
目的 探讨人工全膝关节置换术(TKA)中截骨方法的研究进展.方法 在PubMed、Springer Link、FMJS、万方网络数据库中,以“膝关节置换术”、“截骨”、“计算机导航”和“个体化模板”为关键词,查阅1988年1月-2014年6月有关人工TKA中截骨技术研究的相关文献,进行分析和总结.结果 TKA是治疗中晚期膝关节疾病的标准经典手术,术中截骨方法主要有传统器械截骨、计算机导航及个体化模板辅助截骨等.TKA中传统器械截骨,依靠机械引导装置定位及术者经验截骨,主观性强,精确度较低,手术风险大,并发症多,手术效果欠佳.与传统器械截骨相比,计算机导航辅助截骨精度可能受多种因素影响,需要的时间和并发症发生的概率更多;另外,由于其学习曲线长、设备费用昂贵、技术要求高等众多因素,限制了导航系统的推广应用.个体化模板辅助TKA技术可设计精确化的截骨方法或工具,实现个体化解剖截骨,具有提高截骨精确性、缩短手术时间、减轻手术损伤等优势,膝关节术后功能恢复更加理想.结论 随着数字骨科的不断发展,人工TKA手术方案会更加个性化,截骨更精确.数字化、个体化截骨技术可能成为今后TKA发展的新方向.
目的 探討人工全膝關節置換術(TKA)中截骨方法的研究進展.方法 在PubMed、Springer Link、FMJS、萬方網絡數據庫中,以“膝關節置換術”、“截骨”、“計算機導航”和“箇體化模闆”為關鍵詞,查閱1988年1月-2014年6月有關人工TKA中截骨技術研究的相關文獻,進行分析和總結.結果 TKA是治療中晚期膝關節疾病的標準經典手術,術中截骨方法主要有傳統器械截骨、計算機導航及箇體化模闆輔助截骨等.TKA中傳統器械截骨,依靠機械引導裝置定位及術者經驗截骨,主觀性彊,精確度較低,手術風險大,併髮癥多,手術效果欠佳.與傳統器械截骨相比,計算機導航輔助截骨精度可能受多種因素影響,需要的時間和併髮癥髮生的概率更多;另外,由于其學習麯線長、設備費用昂貴、技術要求高等衆多因素,限製瞭導航繫統的推廣應用.箇體化模闆輔助TKA技術可設計精確化的截骨方法或工具,實現箇體化解剖截骨,具有提高截骨精確性、縮短手術時間、減輕手術損傷等優勢,膝關節術後功能恢複更加理想.結論 隨著數字骨科的不斷髮展,人工TKA手術方案會更加箇性化,截骨更精確.數字化、箇體化截骨技術可能成為今後TKA髮展的新方嚮.
목적 탐토인공전슬관절치환술(TKA)중절골방법적연구진전.방법 재PubMed、Springer Link、FMJS、만방망락수거고중,이“슬관절치환술”、“절골”、“계산궤도항”화“개체화모판”위관건사,사열1988년1월-2014년6월유관인공TKA중절골기술연구적상관문헌,진행분석화총결.결과 TKA시치료중만기슬관절질병적표준경전수술,술중절골방법주요유전통기계절골、계산궤도항급개체화모판보조절골등.TKA중전통기계절골,의고궤계인도장치정위급술자경험절골,주관성강,정학도교저,수술풍험대,병발증다,수술효과흠가.여전통기계절골상비,계산궤도항보조절골정도가능수다충인소영향,수요적시간화병발증발생적개솔경다;령외,유우기학습곡선장、설비비용앙귀、기술요구고등음다인소,한제료도항계통적추엄응용.개체화모판보조TKA기술가설계정학화적절골방법혹공구,실현개체화해부절골,구유제고절골정학성、축단수술시간、감경수술손상등우세,슬관절술후공능회복경가이상.결론 수착수자골과적불단발전,인공TKA수술방안회경가개성화,절골경정학.수자화、개체화절골기술가능성위금후TKA발전적신방향.
Objective To evaluate the research progress of osteotomy technique in total knee arthroplasty (TKA).Methods To analyze and summarize all the related literatures about the osteotomy technique in TKA by the key words of TKA,bone cutting,computer navigation and individual template in the database of PubMed,Springer Link,FMJS and Wanfang data from January 1988 to June 2014.Results TKA became standard classic surgery in the treatment of middle-late knee joint diseases,and the methods in the process of bone cutting included mainly traditional instruments,computer navigation and individual template.In traditional TKA,bone cutting was operated depending for mechanical guided localization and the experience of surgeons with a strong subjectivity,low precision,high risk and poor operative results.Compared with traditional operations,many factors affected the accuracy of bone cutting,consumed much time and higher complication rate in computer navigation assisted TKA.Besides,the long training time,the high expense of equipment and high technical requirement limited the application of the navigation system.The technology of individual template could design accurate cutting method or tool to realize individual operation for TKA.This method had advantages of improving accuracy,reducing the operation time and the surgical injury,and the post-operation recovery was good for the knee joint.Conclusions With the continuous development of digital orthopedics,TKA surgery scheme will be more personalized,more accurate bone cutting.Digital and individualized bone cutting technology will become the new direction of the development of the TKA in the future.
