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摘要 膝关节单髁置换术(unicompartmental knee arthroplasty,UKA)治疗前内侧膝关节骨关节炎已临床应用40余年,其疗效已经被广泛肯定,是膝关节阶梯化治疗领域里的重要治疗方法。目前临床应用较多的是骨水泥型UKA。而随着材料学、假体制作工艺的进步,自2008年以来多款生物型单髁假体相继上市并在临床广泛应用,主要包括Unix UKA、AMC UKA、Uniglide UKA、Alpina UKA和牛津膝关节单髁置换术(Oxford unicompartmental knee arthroplasty,OUKA),其中生物型OUKA假体在临床应用最为广泛。多项研究均证实生物型OUKA术后远期生存率与骨水泥型OUKA基本相同,且在降低生理性透亮线(radiolucent lines,RLLs)发生率、缩短手术时间等多个方面优于骨水泥型假体。但近年来多篇个案报告了与生物型固定方式相关的OUKA术后假体松动,提示生物型OUKA的治疗技术与骨水泥型OUKA存在不同,而且失败的方式也可能存在差异。本文查阅近年来国内外关于生物型OUKA技术应用的相关文献,并进行总结分析,从生物型与骨水泥型OUKA假体的差别和临床应用中面临的问题等方面对生物型OUKA假体的研究进行了综述。
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基金资助:首都卫生发展科研专项基金(首发2018-2-2012) |
通讯作者:
曹光磊
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作者简介: 杨光中(1994- ),男,医师,首都医科大学宣武医院骨科,100032。 |
[1]Price AJ,Svard U.A second decade lifetable survival analysis of the Oxford unicompartmental knee arthroplasty[J].Clin Orthop Relat Res,2011,469(1):174-179.
[2]刘朴,席刚,张润杰,等.膝关节单髁置换术治疗前内侧骨关节炎的研究进展[J].实用骨科杂志,2020,26(6):523-526.
[3]Campi S,Pandit HG,Oosthuizen CR.The Oxford medial unicompartmental knee arthroplasty:the south african experience[J].J Arthroplasty,2018,33(6):1727-1731.
[4]Pandit HG,Campi S,Hamilton TW,et al.Five-year experience of cementless Oxford unicompartmental knee replacement[J].Knee Surg Sports Traumatol Arthrosc,2017,25(3):694-702.
[5]Panzram B,Bertlich I,Reiner T,et al.Cementless Oxford medial unicompartimental knee replacement:an independent series with a 5-year-follow-up[J].Arch Orthop Trauma Surg,2017,137(7):1011-1017.
[6]Mohammad HR,Kennedy JA,Mellon SJ,et al.Ten-year clinical and radiographic results of 1000 cementless Oxford unicompartmental knee replacements[J].Knee Surg Sports Traumatol Arthrosc,2020,28(5):1479-1487.
[7]孙孟帅,曹晓瑞,闫昭,等.非骨水泥型膝关节假体的临床应用进展[J].中华骨与关节外科杂志,2018,11(3):233-236.
[8]李鹏飞,David Murray,曾意荣,等.生物型牛津单髁膝关节假体研究进展[J].中医正骨,2017,29(12):45-47.
[9]Jaeger S,Rieger JS,Bruckner T,et al.The protective effect of pulsed lavage against implant subsidence and micromotion for cemented tibial unicompartmental knee components:an experimental cadaver study[J].J Arthroplasty,2014,29(4):727-732.
[10]Karataglis D,Agathangelidis F,Papadopoulos P,et al.Arthroscopic removal of impinging cement after unicompartmental knee arthroplasty[J].Hippokratia,2012,16(1):76-79.
[11]Kim WY,Shafi M,Kim YY,et al.Posteromedial compartment cement extrusion after unicompartmental knee arthroplasty treated by arthroscopy:a case report[J].Knee Surg Sports Traumatol Arthrosc,2006,14(1):46-49.
[12]Jung KA,Lee SC,Song MB.Lateral meniscus and lateral femoral condyle cartilage injury by retained cement after medial unicondylar knee arthroplasty[J].J Arthroplasty,2008,23(7):1086-1089.
[13]Bhutta MA,Doorgakant A,Marynissen H.Tibial nerve impingement secondary to posterior cement extrusion after unicompartmental knee arthroplasty[J].J Arthroplasty,2010,25(7):1117-1168.
[14]Campi S,Mellon SJ,Ridley D,et al.Optimal interference of the tibial component of the cementless Oxford Unicompartmental Knee Replacement[J].Bone Joint Res,2018,7(3):226-231.
[15]Mohammad HR,Campi S,Murray D,et al.Instruments to reduce the risk of tibial fracture following cementless unicompartmental knee replacement[J].Knee,2018,25(6):988-996.
[16]Kendrick BJ,James AR,Pandit H,et al.Histology of the bone-cement interface in retrieved Oxford unicompartmental knee replacements[J].Knee,2012,19(6):918-922.
[17]Blaney J,Harty H,Doran E,et al.Five-year clinical and radiological outcomes in 257 consecutive cementless Oxford medial unicompartmental knee arthroplasties[J].Bone Joint J,2017,99(5):623-631.
[18]Liddle AD,Pandit H,O'Brien S,et al.Cementless fixation in Oxford unicompartmental knee replacement:a multicentre study of 1000 knees[J].Bone Joint J,2013,95(2):181-187.
[19]van Dorp KB,Breugem SJ,Bruijn DJ,et al.Promising short-term clinical results of the cementless Oxford phase Ⅲ medial unicondylar knee prosthesis[J].World J Orthop,2016,7(4):251.
[20]Andersen MR,Winther NS,Lind T,et al.Low preoperative BMD is related to high migration of tibia components in uncemented TKA-92 patients in a combined DEXA and RSA study with 2-year follow-up[J].J Arthroplasty,2017,32(7):2141-2146.
[21]Petersen MM,Nielsen PT,Lebech A,et al.Preoperative bone mineral density of the proximal tibia and migration of thetibial component after uncemented total knee arthroplasty[J].J Arthroplasty,1999,14(1):77-81.
[22]Linde KN,Madsen F,Puhakka KB,et al.Preoperative systemic bone quality does not affect tibial component migration in knee arthroplasty:a 2-year radiostereometric analysis of hundred consecutive patients[J].J Arthroplasty,2019,34(10):2351-2359.
[23]Mohammad HR,Kennedy JA,Mellon SJ,et al.The clinical outcomes of cementless unicompartmental knee replacement in patients with reduced bone mineral density[J].J Orthop Surg Res,2020,15(1):35.
[24]Knifsund J,Reito A,Haapakoski J,et al.Short-term survival of cementless Oxford unicondylar knee arthroplasty based on the Finnish Arthroplasty Register[J].Knee,2019,26(3):768-773.
[25]Panzram B,Bertlich I,Reiner T,et al.Cementless unicompartmental knee replacement allows early return to normal activity[J].BMC Musculoskelet Disord,2018,19(1):18.
[26]Liddle AD,Pandit HG,Jenkins C,et al.Valgus subsidence of the tibial component in cementless Oxford unicompartmental knee replacement[J].Bone Joint J,2014,96(3):345-349.
[27]Kamenaga T,Hiranaka T,Nakanishi Y,et al.Valgus subsidence of the tibial component caused by tibial component malpositioning in cementless Oxford mobile-bearing unicompartmental knee arthroplasty[J].J Arthroplasty,2019,34(12):3054-3060.
[28]Yildirim G,Gopalakrishnan A,Davignon RA,et al.Comparative fixation and subsidence profiles of cementless unicompartmental knee arthroplasty implants[J].J Arthroplasty,2016,31(9):2019-2024.
[29]Kamenaga T,Hiranaka T,Takayama K,et al.Adequate positioning of the tibial component is key to avoiding bearing impingement in Oxford unicompartmental knee arthroplasty[J].J Arthroplasty,2019,34(11):2606-2613.
[30]Clarius M,Aldinger PR,Bruckner T,et al.Saw cuts in unicompartmental knee arthroplasty:an analysis of Sawbonepreparations.[J].Knee,2009,16(5):314-316.
[31]Inoue S,Akagi M,Asada S,et al.The valgus inclination of the tibial component increases the risk of medial tibial condylar fractures in unicompartmental knee arthroplasty[J].J Arthroplasty,2016,31(9):2025-2030.
[32]Clarius M,Haas D,Aldinger PR,et al.Periprosthetic tibial fractures in unicompartmental knee arthroplasty as a function of extended sagittal saw cuts:an experimental study[J].Knee,2010,17(1):57-60.
[33]Seeger JB,Haas D,Jger S,et al.Extended sagittal saw cut significantly reduces fracture load in cementless unicompartmental knee arthroplasty compared to cemented tibia plateaus:an experimental cadaver study[J].Knee Surg Sports Traumatol Arthrosc,2012,20(6):1087-1091.
[34]Uehara K,Kadoya Y,Kobayashi A,et al.Anthropometry of the proximal tibia to design a total knee prosthesis for the Japanese population[J].J Arthroplasty,2002,17(8):1028-1032.
[35]Kwak DS,Surendran S,Pengatteeri YH,et al.Morphometry of the proximal tibia to design the tibial component of total knee arthroplasty for the Korean population[J].Knee,2007,14(4):295-300.
[36]Liddle AD,Pandit H,Murray DW,et al.Cementless unicondylar knee arthroplasty[J].Orthop Clin North Am,2013,44(3):261-269.
[37]Inui H,Taketomi S,Yamagami R,et al.Femoral migration of the cementless Oxford which caused the bearing dislocation:a report of two cases[J].BMC Musculoskelet Disord,2020,21(1):356. |
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