骨水泥技术与力线微偏差  

Bone cement and intra-operative deviation in limb alignment in total knee arthroplasty

作　　者：刘克敏[1,2] 亓攀 闵红巍 曲铁兵[1,2] 

机构地区：[1]北京博爱医院关节病诊疗中心,100068 [2]首都医科大学骨外科学系,北京100068

出　　处：《中华关节外科杂志（电子版）》2017年第5期73-77,共5页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：国家自然科学基金(81572180)

摘　　要：目的探讨骨水泥分布特征对人工膝关节表面置换(TKA)术中机械力线微偏差的影响。方法回顾性分析北京博爱医院关节病诊疗中心45例TKA手术(排除铰链假体和翻修病例)后X线平片胫骨侧骨水泥分布特征(楔形征角度a),研究骨水泥的使用特点以及其在胫骨侧的分布不均现象。结合文献和著者的临床实践经验,阐述骨水泥分布不均是否会影响下肢力线的精确性。结果 45例TKA中,9例(20%)发现存在不同程度的胫骨侧骨水泥分布不均,a角≤1°者4例、1°~3°者3例、≥3°者2例,平均(1.89±1.17)°。结论 TKA术中,骨水泥分布不均会导致下肢力线发生一定的偏差;利用骨水泥的可塑性在假体安装的最后阶段可对下肢力线的微偏差进行更精确的调整。Objective The primary purpose of this study was to investigate the effect of bone cement use on the intra-operative deviation in limb alignment in total knee arthroplasty（ TKA）. Methods A retrospective review of 45 cases with anteroposterior view of knee radiographs after TKA was undertaken to confirm the distribution characteristics of cement on tibial side; hinge prosthesis and revision cases were excluded. Whether the thickness imbalance of bone cement（ cement-wedge sign） influenced the accuracy of limb alignment was articulated. Results A total of 45 subjects were analyzed,angle a ≤ 1° in four cases,angle a was 1° to 3° in three cases,angle a ≥ 3° in two cases. Conclusion Bone cement can influence the accuracy of limb alignment,and can help the surgeon make a correction in the doughy stage to improve alignment and reduce outliers.

关 键 词：关节成形术 置换 膝 下肢 骨黏合剂 

分 类 号：R687.4[医药卫生—骨科学]