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中华关节外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (01) : 98 -105. doi: 10.3877/cma.j.issn.1674-134X.2023.01.014

综述

全膝关节置换术下肢对线的研究进展
闫自晓1, 王俏杰1, 张先龙1,†()   
  1. 1. 200233　上海交通大学医学院附属第六人民医院骨科
  • 收稿日期:2022-07-22 出版日期:2023-02-01
  • 通信作者: 张先龙

Research progerss in lower limb alignment for total knee arthroplasty

Zixiao Yan1, Qiaojie Wang1, Xianlong Zhang1,†()   

  1. 1. Department of Orthopedics, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People′s Hospital, Shanghai 200233, China
  • Received:2022-07-22 Published:2023-02-01
  • Corresponding author: Xianlong Zhang
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闫自晓, 王俏杰, 张先龙. 全膝关节置换术下肢对线的研究进展[J/OL]. 中华关节外科杂志(电子版), 2023, 17(01): 98-105.

Zixiao Yan, Qiaojie Wang, Xianlong Zhang. Research progerss in lower limb alignment for total knee arthroplasty[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(01): 98-105.

全膝关节置换术(TKA)是骨科中最具有成本效益的手术之一，被广泛认为是治疗有症状的终末期膝关节骨关节炎的金标准。现阶段机械轴对线是TKA中应用最为广泛的一种下肢对线方式。然而，大约只有80%的患者对该手术表示满意。随着技术的发展，假体的设计和手术的精度都有所改进，但TKA的临床及功能结果并没有明显改善。因此，外科医生提出了多种个性化的对线方法，如改良机械轴对线、解剖学对线、运动学对线、限制性运动学对线、反运动学对线、功能性对线以及边界性中立位对线等，并希望通过对比不同对线方式的临床及功能结果，找到最佳对线方式，从而提高患者满意度。本文对现阶段以上几种对线理念及其对比研究结果进行了阐述。

关键词: 膝, 膝关节, 骨关节炎, 关节成形术，置换, 解剖学

Total knee arthroplasty (TKA) is one of the most cost-effective procedures in orthopaedics and is widely considered the gold standard for the treatment of symptomatic end-stage knee osteoarthritis. At present, mechanical alignment is the most widely used method for lower limb alignment in TKA. However, only about 80% of patients are satisfied with the mechanical alignment.With the development of technologies, the prosthesis design and operation accuracy have been improved, but the clinical and functional outcomes of TKA have not been improved significantly. Therefore, more surgeons start seek individualised alignment methods, such as adjusted mechanical alignment, anatomical alignment, kinematic alignment, restricted kinematic alignment, inverse kinematic alignment, functional alignment, and neutral boundary alignment, and hope to improve patient satisfaction by comparing the clinical and functional outcomes of different alignment methods and seeking the optimal alignment. This paper elaborated on the alignment concepts and the comparative studies.

Key words: Knee, Knee joint, Osteoarthritis, Arthroplasty, replacement, Anatomy
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