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[1]毛勇.脛骨平臺前緣圓弧頂點(diǎn)作為脛骨假體旋轉(zhuǎn)定位標(biāo)志對脛股關(guān)節(jié)接觸力學(xué)指標(biāo)的影響[J].中醫(yī)正骨,2020,32(06):7-11.
　MAO Yong.Effects of using vertex of curved anterior border of tibial plateau as tibial prosthesis rotational positioning mark on contact mechanics indexes of tibiofemoral joint[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(06):7-11.
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脛骨平臺前緣圓弧頂點(diǎn)作為脛骨假體旋轉(zhuǎn)定位標(biāo)志對脛股關(guān)節(jié)接觸力學(xué)指標(biāo)的影響()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年06期
頁碼:
7-11
欄目:
基礎(chǔ)研究
出版日期:
2020-06-20

文章信息/Info

Title:
Effects of using vertex of curved anterior border of tibial plateau as tibial prosthesis rotational positioning mark on contact mechanics indexes of tibiofemoral joint
作者:
毛勇
(廣州市番禺區(qū)中醫(yī)院,廣東廣州511400)
Author(s):
MAO Yong
Panyu Hospital of Chinese Medicine,Guangzhou 511400,Guangdong,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 膝;  脛骨;  定位標(biāo)記;  生物力學(xué);  可行性研究
Keywords:
arthroplasty; replacement; knee;  tibia;  fiducial markers;  biomechanics;  feasibility studies
摘要:
目的:觀察脛骨平臺前緣圓弧頂點(diǎn)作為脛骨假體旋轉(zhuǎn)定位標(biāo)志對脛股關(guān)節(jié)接觸力學(xué)指標(biāo)的影響。方法:將6具成人膝關(guān)節(jié)尸體標(biāo)本分為3組,每組2具標(biāo)本,由同一組具備高級職稱的醫(yī)生使用PS型固定平臺假體實(shí)施全膝關(guān)節(jié)置換術(shù)(total knee arthroplasty,TKA)。觀察組以脛骨平臺前緣圓弧頂點(diǎn)作為脛骨假體旋轉(zhuǎn)定位參考,對照1組以脛骨結(jié)節(jié)中內(nèi)13作為脛骨假體旋轉(zhuǎn)定位參考,對照2組以自我形合法確定脛骨假體旋轉(zhuǎn)定位對線。術(shù)后將膝關(guān)節(jié)標(biāo)本固定在WDW4100萬能試驗(yàn)機(jī)上,測定3組膝關(guān)節(jié)標(biāo)本的脛股關(guān)節(jié)內(nèi)側(cè)總應(yīng)力、外側(cè)總應(yīng)力、內(nèi)側(cè)接觸面積、外側(cè)接觸面積、內(nèi)側(cè)接觸應(yīng)力、外側(cè)接觸應(yīng)力、內(nèi)側(cè)接觸應(yīng)力峰值及外側(cè)接觸應(yīng)力峰值。結(jié)果:6具膝關(guān)節(jié)標(biāo)本假體均順利安裝完成,脛骨假體位置無明顯差異。3組標(biāo)本的脛股關(guān)節(jié)內(nèi)側(cè)總應(yīng)力[(1.59±0.15)Pa,(1.65±0.01)Pa,(1.71±0.12)Pa,F=1.838,P=0.172]、外側(cè)總應(yīng)力[(2.65±0.34)Pa,(2.52±0.13)Pa,(2.41±0.21)Pa,F=1.742,P=0.087]、內(nèi)側(cè)接觸面積[(17.35±1.12)cm2,(19.26±1.32)cm2,(18.96±0.92)cm2,F=1.311,P=0.093]、外側(cè)接觸面積[(13.91±1.81)cm2,(14.47±0.92)cm2,(14.77±0.81)cm2,F=1.983,P=0.131]、內(nèi)側(cè)接觸應(yīng)力[(3.97±1.05)Pa,(3.57±0.05)Pa,(4.07±0.17)Pa,F=1.363,P=0.069]、外側(cè)接觸應(yīng)力[(2.52±0.71)Pa,(2.22±0.03)Pa,(1.98±0.13)Pa,F=1.965,P=0.072]、內(nèi)側(cè)接觸應(yīng)力峰值[(6.21±0.32)Pa,(6.65±0.07)Pa,(6.37±0.16)Pa,F=1.682,P=0.153]、外側(cè)接觸應(yīng)力峰值[(5.74±0.19)Pa,(5.56±0.09)Pa,(5.38±0.32)Pa,F=1.256,P=0.086]比較,組間差異均無統(tǒng)計(jì)學(xué)意義。結(jié)論:TKA手術(shù)中以脛骨平臺前緣圓弧頂點(diǎn)作為脛骨假體旋轉(zhuǎn)定位標(biāo)志,術(shù)后脛股關(guān)節(jié)接觸力學(xué)特征與以往常用定位方法相當(dāng),可作為TKA手術(shù)中脛骨假體旋轉(zhuǎn)定位的參考標(biāo)志。
Abstract:
Objective:To observe the effects of using vertex of curved anterior border of tibial plateau as tibial prosthesis rotational positioning mark on contact mechanics indexes of tibiofemoral joint(TFJ).Methods:Six knee specimens from 3 adult cadavers were selected and divided into observation group,control group 1 and control group 2,2 cases in each group.Total knee arthroplasty(TKA)was performed by the same group of surgeons with senior professional titles by using type PS fixed-bearing prosthesis.The vertex of curved anterior border of tibial plateau and the junction of the medial one third and lateral two thirds of tibial tubercle were used as the reference points for tibial prosthesis rotational positioning in observation group and control group 1 respectively,and tibial prosthesis rotational positioning alignment was confirmed by using self-hypotaxis method in control group 2.The knee specimens were fixed on WDW4100 universal testing machine after the surgery.The medial and lateral total stress,contact area,contact stress and peak contact stress of TFJ of knee specimens were measured and compared between the 3 groups.Results:The prostheses installation were finished successfully in all knee specimens,and there was no significant difference in the position of tibial prostheses.There was no statistical difference in medial and lateral total stress,contact area,contact stress and peak contact stress of TFJ of knee specimens between the 3 groups(1.59+-0.15,1.65+-0.01,1.71+-0.12 Pa,F=1.838,P=0.172; 2.65+-0.34,2.52+-0.13,2.41+-0.21 Pa,F=1.742,P=0.087; 17.35+-1.12,19.26+-1.32,18.96+-0.92 cm(2),F=1.311,P=0.093; 13.91+-1.81,14.47+-0.92,14.77+-0.81 cm(2),F=1.983,P=0.131; 3.97+-1.05,3.57+-0.05,4.07+-0.17 Pa,F=1.363,P=0.069; 2.52+-0.71,2.22+-0.03,1.98+-0.13 Pa,F=1.965,P=0.072; 6.21+-0.32,6.65+-0.07,6.37+-0.16 Pa,F=1.682,P=0.153; 5.74+-0.19,5.56+-0.09,5.38+-0.32 Pa,F=1.256,P=0.086).Conclusion:The method of using vertex of curved anterior border of tibial plateau as tibial prosthesis rotational positioning mark in surgery of TKA is similar to conventional positioning methods in postoperative TFJ contact mechanical characteristics,so the vertex of curved anterior border of tibial plateau can be used as a reference mark for tibial prosthesis rotational positioning during the TKA surgery.

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(收稿日期:2019-06-07本文編輯:李曉樂)
更新日期/Last Update: 2020-10-10