具有双屈伸运动人工半膝关节假体运动参数分析及实验性临床研究  

Motion parameters analysis and pilot clinical trials of the dual mobility hemi-knee artificial prosthesis

作　　者：革军[1] 王臻[1] 刘鹏[1] 栗向东[1] 陈国景[1] 

机构地区：[1]第四军医大学西京医院骨科,西安710032

出　　处：《中华骨科杂志》2012年第5期482-488,共7页Chinese Journal of Orthopaedics

摘　　要：目的针对儿童股骨下段恶性骨肿瘤的诸多治疗方法中存在的问题，本课题组首次提出具有双屈伸运动人工半膝关节（双动半膝关节）的概念，进行其运动轨迹规律及实验性临床研究。方法以Mimics／Geomagic／Pro—E软件的设计路线为技术路线。基于成人膝关节标本的CT数据，利用数控铣床机加工制作双动半膝关节假体，进行体外实验研究其运动参数特点，最后进行实验性临床研究。结果离体实验结果：股骨内侧髁屈曲面球心位移在正常膝关节组为（2．59±0．43）mm，双动半膝关节组为（2．22±0．52）mm，全膝关节组为（1．18±0．43）mm；股骨外侧髁屈曲面球心位移在正常膝关节组为（11．95±6．62）mm，双动半膝关节组为（11．25±6．19）mm，全膝关节组为（1．26±0．42）mm；相对胫骨最大旋转角度在正常膝关节组为13．17°±7．58°，双动半膝关节组为11．69°±6．49°，全膝关节组为5．40°±1.29°。完成探索性临床试验，术后患者恢复良好，效果满意。结论运动参数分析证明双动半膝关节接近正常膝关节运动模式，双动半膝关节为治疗儿童股骨下段恶性肿瘤提供了全新的理念和思路，新型附丽概念和新型韧带附丽装置为膝关节韧带功能重建提出新的解决方案。Objective Aim at the problems in the treatments of the children malignant bone tumor of distal femur, we put forward the concept of the duai mobility hemi-knee prosthesis and try to perform the motion parameters analysis and the pilot clinical trials. Methods Base on the CT data from samples of knee joint in adult, we adopted the Mimics/Geomagic/Pro-E software and computer numerical control milling machine technology to design and produce the dual mobility hemi-knee artificial prosthesis, and then motion parameters was analyzed in vitro test, and at last pilot clinical trial was performed. Results In vitro experiment showed that the displacement of the internal femoral condyle flexion facet center was （2.59±0.43） mm in normal knee group, （2.22±0.52） mm in dual mobility hemi-knee prosthesis group, and （1.18±0.43） mm in total knee arthroplasty group; the displacement of the external femoral condyle flexion facet center was （11.95±6.62） mm in normal group, （11.25±6.19） mm in dual mobility hemi-knee prosthesis group, and （1.26± 0.42） mm in total knee arthroplasty group; the maximum relative rotation angle was 13.17°±7.58° in normal knee group, 11.69°±6.49° in dual mobility hemi-knee prosthesis group, and 5.40°±1.29° in total knee arthroplasty group. After that, we accomplished the pilot clinical trials successfully for a patient with malignant bone tumor in distal femur. The patient recovered well and the treatment outcome was satisfactory. Conclu- sion The motion parameters analysis showed that the motion mode of the dual mobility hemi-knee prosthe- sis is similar with that of the normal knee. The dual mobility hemi-knee prosthesis provides a whole new concept and method for the treatment of malignant bone tumor of distal femur in children, and the device and concept of ligament reattachment provide a solution to the reconstruction of knee ligament.

关 键 词：膝关节 人工 骨肿瘤 临床试验 

分 类 号：R738.1[医药卫生—肿瘤] R318.1[医药卫生—临床医学]