全膝置换中股骨假体轴向旋转对线与髌股关节生物性能的变化  

Axial rotation alignment of the femoral prosthesis in total knee arthroplasty and biological effect of patellofemoral joint

作　　者：杨军 

机构地区：[1]河南中医学院第二附属医院(河南省中医院)关节科,河南省郑州市450002

出　　处：《中国组织工程研究》2016年第13期1838-1844,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:全膝置换中需要使用股骨假体,假体会产生一定的轴向旋转对线,并影响到到髌股关节的生物性能。目的:探讨全膝置换中股骨假体轴向旋转对线对髌股关节生物性能的影响。方法:从河南中医学院第二附属医院(河南省中医院)标本室获得10个新鲜人尸体膝关节,建立膝关节实验平台,模拟人体踝关节和髋关节,提供3个胫骨自由度以及2个股骨自由度。测定股骨假体旋转角度,实施全膝关节置换,利用敏感型压敏片测定以经股骨上髁轴内旋2°、经股骨上髁轴外旋2°、经股骨上髁轴内旋4°、与经股骨上髁轴平行、股骨上髁轴外旋4°、与Whiteside线平行情况下的髌股接触压以及髌股接触面积。结果与结论:对股骨假体轴向与经股骨上髁轴平行方位旋转的关节内、外侧峰值接触压均处于较为均衡的状态,且与其他方式旋转的关节内、外侧峰值接触压差异有显著性意义(P<0.05)。股骨假体轴向不同旋转方位髌股接触面积差异无显著性意义。表明全膝置换中股骨假体轴向旋转对线会对髌股关节生物性能产生一定的影响,经股骨上髁轴平行状态下髌股关节内、外侧峰值接触压未出现一侧过低或者过高的情况,处于较为均衡的状态,术中可以选择将其作为股骨假体旋转对线参照标准。BACKGROUND： Total knee arthroplasty needs to use the femoral prosthesis. The prosthesis will produce a certain axial rotation on the line, and affect the biological properties of the patellofemoral joint. OBJECTIVE： To explore the effect of axial rotation of prosthesis on biological effect of the patellofemoral joint in total knee arthroplasty.METHODS： Ten fresh human cadaver knees were obtained from the Specimen Room of Second Affiliated Hospital（Henan Province Hospital of Traditional Chinese Medicine） of Henan University of Traditional Chinese Medicine. Knee joint experimental platform was established to simulate the human ankle and hip joint, providing 3 degrees of freedom of tibia and 2 degrees of freedom of femur. Femoral component rotation angle was measured. Total knee arthroplasty was conducted. The sensitive pressure-sensitive film was used to measure the transepicondylar axis rotation of 2°, 2° through the femoral epicondylar axis rotation, the femoral epicondylar axis rotation of 4°, and parallel to the femoral epicondylar axis, external rotation of the femoral epicondylar axis 4°, and the patellofemoral contact pressure and patellofemoral contact area parallel with Whiteside＇s line. RESULTS AND CONCLUSION： The peak contact pressure inside and outside the joint at different axial rotation of the femoral prosthesis paralleled with femoral epicondylar axis was in a balanced state, and significant differences were detected as compared with other rotation manners（P 0.05）. No significant difference was found in patellofemoral contact area at different directions. These findings suggest that femoral prosthesis axial rotation on the line in total knee arthroplasty will have a certain effect on biological properties of patellofemoral joint. The peak contact pressure inside and outside patellofemoral joint in the parallel state of the femoral epicondylar axis does not appear excessive low or high state on one side, but in a balanced state. It can be chosen as a reference standard of rotati

关 键 词：生物假体 关节 组织工程 骨科植入物 人工假体 全膝置换 股骨 假体旋转 旋转对线 髌股关节 经股骨上髁 生物性能 

分 类 号：R318[医药卫生—生物医学工程]