人工全膝关节置换术中股骨前皮质切迹的研究进展  

Research progress of anterior femoral notching in total knee arthroplasty

作　　者：张金成 冯硕 张乐曙 周航 陈向阳 ZHANG Jincheng;FENG Shuo;ZHANG Leshu;ZHOU Hang;CHEN Xiangyang(Department of Joint Surgery,Affiliated Hospital ofXuzhou Medical University,Xuzhou Jiangsu,221006,P.R.China)

机构地区：[1]徐州医科大学附属医院关节外科,江苏徐州221006

出　　处：《中国修复重建外科杂志》2021年第11期1499-1504,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的总结人工全膝关节置换术(total knee arthroplasty,TKA)中股骨前皮质切迹的产生原因及预防方法。方法广泛查阅近年国内外相关文献,总结TKA术中股骨前皮质切迹的产生原因及预防方法。结果股骨前皮质切迹发生的原因主要有以下几点:后参考技术的应用、后髁角的增大、变异的股骨前皮质解剖形态、股骨假体大小的可选择性减少、进髓点后移,以及计算机导航技术或个性化截骨技术的应用。预防股骨前皮质切迹的发生可采用弯曲股骨假体放置、机器人辅助技术和前后参考技术联合等方案。结论股骨前皮质切迹是一种常见的TKA术后并发症,完备术前计划,评估患者膝关节状况,制定合理手术方案,可以有效减少股骨前皮质切迹的发生。Objective To summarize the research progress of the causes and prevention methods of anterior femoral notching in total knee arthroplasty(TKA). Methods The related literature at home and abroad about the causes and prevention methods of the anterior femoral notching in TKA was extensively reviewed and summarized.Results The reasons for the occurrence of anterior femoral notching can be summarized as follows: the application of the posterior reference technique, the increase of the posterior condylar angle, the variant anatomical shape of anterior femoral cortex, the selective reduction of the femoral prosthesis size, backward movement of the entrance point, and the application of computer-assisted navigation technology or patient-specific instrumentation. To prevent the occurrence of anterior femoral notching, programs such as flex the femoral prosthesis, robot-assisted technology, and anterior and posterior reference techniques combination can be used. Conclusion Anterior femoral notching is a common surgical complication of TKA. A complete preoperative plan, assessment of the patient’s knee joint condition, and development of a reasonable surgical plan can effectively reduce the occurrence of anterior femoral notching.

关 键 词：人工全膝关节置换术 股骨前皮质切迹 计算机辅助导航技术 前后参考技术联合 

分 类 号：R687.4[医药卫生—骨科学]