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中华关节外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (01) : 67 -73. doi: 10.3877/cma.j.issn.1674-134X.2022.01.011

综述

全膝关节置换术中股骨远端截骨定位方式的研究进展
关正瑞1, 王春雷1, 曲彦隆1,()   
  1. 1. 150001 哈尔滨医科大学附属第一医院骨三科
  • 收稿日期:2020-06-05 出版日期:2022-02-01
  • 通信作者: 曲彦隆

Research progress of alignment of distal femoral osteotomy in total knee arthroplasty

Zhengrui Guan1, Chunlei Wang1, Yanlong Qu1,()   

  1. 1. The Third Department of Orthopedics, The First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
  • Received:2020-06-05 Published:2022-02-01
  • Corresponding author: Yanlong Qu
引用本文:

关正瑞, 王春雷, 曲彦隆. 全膝关节置换术中股骨远端截骨定位方式的研究进展[J/OL]. 中华关节外科杂志(电子版), 2022, 16(01): 67-73.

Zhengrui Guan, Chunlei Wang, Yanlong Qu. Research progress of alignment of distal femoral osteotomy in total knee arthroplasty[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(01): 67-73.

全膝关节置换术(TKA)是当前公认的治疗终末期膝关节骨关节炎的最有效措施,一次成功的TKA依赖于下肢力线的重建效果。股骨远端截骨准确是患者术后膝关节的间隙平衡的关键所在。目前股骨远端截骨定位的方法主要包括:髓内杆定位、髓外定位技术、计算机辅助导航定位技术、患者个性化截骨导板定位技术等。本文通过对国内外文献的查阅,对各种定位方式的优势与劣势作分析与综述。

Total knee arthroplasty (TKA) is recognized as the most effective treatment for end-stage knee osteoarthritis currently. A successful TKA depends on the rebuild effect of the lower limbs alignment. The accurate osteotomy of the distal femur is the key to the balance of the knee joint after the patient's operation. The current methods for positioning the distal femoral osteotomy mainly include: intramedullary alignment, extramedullary alignment, computer-aided navigation alignment, and patient-specific instrumentation. This review analyzed and summarized the advantages and disadvantages of various alignment by consulting domestic and foreign documents.

图1 股骨远端截骨导板旋转对截骨平面的影响[24]。图A示截骨导板处于外旋位;图B示截骨导板处于中立位;图C示截骨导板处于内旋位注:在正确的股骨远端截骨完成后,重新插入髓内杆并放回截骨导板,与中立位相比,随着截骨导板的内外旋转,截骨导板与截骨面之间存在明显的内外翻及前后倾的偏差
图2 混合现实技术(MR)辅助3D打印个性化截骨导板技术[46]。图A为手术显露的同时,MR全息显示解剖;图B为截骨开始前,MR全息显示手术计划与个性化截骨导板设计
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