CAJ | 학술논문

背景：后稳定型膝关节假体股骨侧需要额外的髁间截骨来容纳胫骨柱和股骨窝结构，髁间窝两侧与股骨体相连处应力集中是骨折好发部位。不同品牌假体不同型号间截骨量的差异并没有具体数据，不便于临床医生在选择假体时参考。 　　目的：比较临床上常用的后稳定型膝关节假体(进口、国产的6个品牌)髁间截骨数据的不同，为临床假体选择和应用提供依据。 　　方法：选择目前国内常用的(进口、国产的6个品牌)后稳定型人工膝关节假体，包括Zimmer NexGen LPS、Stryker Scrorpio NRG Knee-Flexed、Depuy PFC Sigma、Smith&nephew Genesis-2 PS、United-U1及威高 GKPS。根据截骨模板确定截骨面包括股骨髁前截面、后截部、股骨髁远端截面、后斜截面；对应股骨假体径线包括髁内外径宽、髁前后径宽、股骨髁间窝截骨宽度及深度，对上述数据进行对比测量。 　　结果与结论：6种膝关节股骨髁假体的前后径/内外径、髁间窝截骨量及形态均存在差异，国外品牌股骨远端前后截骨面间径线较短，对后髁的截骨程度较大。随着应用假体尺寸的增大，所用品牌髁间截骨宽度所致骨量丢失比例均呈下降趋势，无论是小尺寸假体还是大尺寸假体，Stryker Scrorpio NRG Knee-Flexed假体髁间截骨宽度均较小。6个品牌的膝关节假体截骨尺寸有所不同，以上结果并不足以评价不同假体之间的优劣，但就保留髁间骨储量而言，髁间截骨量少的设计较具优势。
배경：후은정형슬관절가체고골측수요액외적과간절골래용납경골주화고골와결구，과간와량측여고골체상련처응력집중시골절호발부위。불동품패가체불동형호간절골량적차이병몰유구체수거，불편우림상의생재선택가체시삼고。 　　목적：비교림상상상용적후은정형슬관절가체(진구、국산적6개품패)과간절골수거적불동，위림상가체선택화응용제공의거。 　　방법：선택목전국내상용적(진구、국산적6개품패)후은정형인공슬관절가체，포괄Zimmer NexGen LPS、Stryker Scrorpio NRG Knee-Flexed、Depuy PFC Sigma、Smith&nephew Genesis-2 PS、United-U1급위고 GKPS。근거절골모판학정절골면포괄고골과전절면、후절부、고골과원단절면、후사절면；대응고골가체경선포괄과내외경관、과전후경관、고골과간와절골관도급심도，대상술수거진행대비측량。 　　결과여결론：6충슬관절고골과가체적전후경/내외경、과간와절골량급형태균존재차이，국외품패고골원단전후절골면간경선교단，대후과적절골정도교대。수착응용가체척촌적증대，소용품패과간절골관도소치골량주실비례균정하강추세，무론시소척촌가체환시대척촌가체，Stryker Scrorpio NRG Knee-Flexed가체과간절골관도균교소。6개품패적슬관절가체절골척촌유소불동，이상결과병불족이평개불동가체지간적우렬，단취보류과간골저량이언，과간절골량소적설계교구우세。
BACKGROUND:Posterior stabilized femoral knee prosthesis needs additional condyle osteotomy to accommodate the tibial post and femur fossa structures. Intercondylar fossa on both sides connected at the femoral body with concentrated stress is a place easily affecting fractures. Differences in bone mass between different models of different brands did not have specific data, which was not convenient to select prosthesis for clinicians. OBJECTIVE: To compare the difference of intercondylar osteotomy data among clinical commonly used posterior stabilized knee prostheses (six imported and domestic brands), and to provide basis for the selection and application of the prostheses. METHODS:The current commonly used posterior stabilized knee prostheses (six imported and domestic brands) were used, including Zimmer NexGen LPS, Stryker Scrorpio NRG Knee-Flexed, Depuy PFC Sigma, Smith & nephew Genesis-2 PS, United-U1 and Wego GKPS. According to the osteotomy template, the osteotomy-surfaces consisting of femoral condyle starting section and cross section, distal section of femoral condyle, and back-oblique section were identified. The corresponding femoral prosthesis diameter lines included condylar ambilateral and anteroposterior diameters, width and depth of femoral intercondylar fossa. The above data were compared and measured. RESULTS AND CONCLUSION:The six kinds of knee femoral prostheses were different in ratio of ambilateral diameter and anteroposterior diameter, bone resection of intercondylar fossa, and geometry. Imported prostheses carry shorter diameters in femoral starting and cross sections, so it can catch more posterior condylar osteotomy. With increasing prosthesis sizes, the ratio of bone loss causing by width of intercondylar osteotomy is decreased among six brands. In al sizes, Stryker Scrorpio NRG Knee-Flexed catches shorter width of intercondylar osteotomy. Knee prosthesis osteotomy among six brands is different. The result of this study is not sufficient to evaluate the pros and cons between different prostheses, but as reserving bone is concerned, the design of less intercondylar osteoomy catches more advantages.