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摘要 膝关节单髁置换术(unicompartmental knee arthroplasty,UKA)诞生于20世纪70年代,在半个世纪的发展中不断更新优化,已在全世界范围广泛开展。近几年国内UKA的手术量也呈现出高速增长的态势。以牛津单髁为例,在国内以每年40%~50%的平均复合增长率连续数年快速增长。但UKA也存在着一定的学习曲线,文献中也指出其翻修率仍然较高,对初学者来说存在着一定的失败率。因此,如何提高单髁手术的成功率与假体生存率一直是研究的热点。
数字骨科结合了骨科临床与计算机数字技术,其涉及到解剖学、材料学、工程学、计算机科学及生物力学等,是一门新兴的交叉学科。目前应用于UKA中的数字技术主要包括计算机辅助、人工智能、虚拟现实、有限元分析及依赖于3D打印的个性化定制假体等技术。合理的应用数字技术将有助于提高UKA假体置入的精准性及可重复性,提高假体存活率、并改善长期预后。本文从数字骨科技术为切入点,综述其在膝关节单髁置换术中的应用。
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通讯作者:
刘宁
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作者简介: 管士坤(1996- ),男,研究生在读,哈尔滨医科大学附属第一医院骨三科,gsk080808@qq.com |
[1]Aleto TJ,Berend ME,Ritter MA,et al.Early failure of unicompartmental knee arthroplasty leading to revision[J].The Journal of arthroplasty,2008,23(2):159-163.
[2]Chen Y,Zhang K,Hao Y,et al.Research status and application prospects of digital technology in orthopaedics[J].Orthop Surg,2012,4(3):131-138.
[3]Jenny JY,Boeri C.Unicompartmental knee prosthesis implantation with a non-image-based navigation system:Rationale,technique,case-control comparative study with a conventional instrumented implantation[J].Knee Surg Sports Traumatol Arthroscopy,2003,11(1):40-45.
[4]Robinson PG,Clement ND,Hamilton D,et al.A systematic review of robotic-assisted unicompartmental knee arthroplasty:Prosthesis design and type should be reported[J].Bone Joint J,2019,101(7):838-847.
[5]Keene G,Simpson D,Kalairajah Y.Limb alignment in computer-assisted minimally-invasive unicompartmental knee replacement[J].J Bone Joint Surg(Br),2006,88(1):44-48.
[6]Manzotti A,Cerveri P,Pullen C,et al.Computer-assisted unicompartmental knee arthroplasty using dedicated software versus a conventional technique[J].Int Orthop,2014,38(2):457-463.
[7]Ma B,Rudan J,Chakravertty R,et al.Computer-assisted fluoro guide navigation of unicompartmental knee arthroplasty[J].Canadian J Surg,2009,52(5):379.
[8]Weber P,Crispin A,Schmidutz F,et al.Improved accuracy in computer-assisted unicondylar knee arthroplasty:A meta-analysis[J].Knee Surg Sport Traumatol Arthroscopy,2013,21(11):2453-2461.
[9]Valenzuela GA,Jacobson NA,Geist DJ,et al.Implant and limb alignment outcomes for conventional and navigated unicompartmental knee arthroplasty[J].J Arthroplasty,2013,28(3):463-468.
[10]Konyves A,Willis-Owen CA,Spriggins AJ.The long-term benefit of computer-assisted surgical navigation in unicompartmental knee arthroplasty[J].J Orthop Surg Res,2010,5(1):1-5.
[11]Leelasestaporn C,Tarnpichprasert T,Arirachakaran A,et al.Comparison of 1-year outcomes between MAKO versus NAVIO robot-assisted medial UKA:nonrandomized,prospective,comparative study[J].Knee Surg Relat Res,2020,32(1):1-9.
[12]Porcelli P,Marmotti A,Bellato E,et al.Comparing different approaches in robotic-assisted surgery for unicompartmental knee arthroplasty:Outcomes at a short-term follow-up of MAKO versus NAVIO system[J].J Biol Regul Homeost Agents,2020,34(4 Suppl 3):393-404.
[13]Blyth MJG,Anthony I,Rowe P,et al.Robotic arm-assisted versus conventional unicompartmental knee arthroplasty:Exploratory secondary analysis of a randomised controlled trial[J].Bone Joint Res,2017,6(11):631-639.
[14]Kayani B,Konan S,Tahmassebi J,et al.Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty:A prospective cohort study[J].Bone Joint J,2018,100(7):930-937.
[15]Kayani B,Konan S,Ayuob A,et al.Robotic technology in total knee arthroplasty:A systematic review[J].Efort Open Rev,2019,4(10):611-617.
[16]Negrín R,Duboy J,Reyes NO,et al.Robotic-assisted unicompartmental knee arthroplasty optimizes joint line restitution better than conventional surgery[J].J Experimental Orthop,2020,7(1):1-8.
[17]MacCallum KP,Danoff JR,Geller JA.Tibial baseplate positioning in robotic-assisted and conventional unicompartmental knee arthroplasty[J].Europ J Orthop Surg Traumatol,2016,26(1):93-98.
[18]Bell SW,Anthony I,Jones B,et al.Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty:Data from a prospective,randomized controlled study[J].J Bone Joint Surg Am,2016,98(8):627-635.
[19]Negrín R,Duboy J,Iiguez M,et al.Robotic-assisted vs conventional surgery in medial unicompartmental knee arthroplasty:A clinical and radiological study[J].Knee Surg Relat Res,2021,33(1):1-7.
[20]Dretakis K,Igoumenou VG.Outcomes of robotic-arm-assisted medial unicompartmental knee arthroplasty:Minimum 3-year follow-up[J].Europ J Orthop Surg Traumat,2019,29(6):1305-1311.
[21]Batailler C,White N,Ranaldi FM,et al.Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty[J].Knee Surg Sport Traumat Arthroscopy,2019,27(4):1232-1240.
[22]Tiulpin A,Thevenot J,Rahtu E,et al.Automatic knee osteoarthritis diagnosis from plain radiographs:A deep learningbased approach[J].Sci Report,2018,8(1):1-10.
[23]Norman B,Pedoia V,Noworolski A,et al.Applying densely connected convolutional neural networks for staging osteoarthritis severity from plain radiographs[J].J Digital Imaging,2019,32(3):471-477.
[24]Fucentese SF,Koch PP.A novel augmented reality-based surgical guidance system for total knee arthroplasty[J].Archives Orthop Trauma Surg,2021,141(12):2227-2233.
[25]彭鳒侨,白波.关节置换虚拟手术的数字化背景[J].中华关节外科杂志(电子版),2014,8(5):659-663.
[26]Zaid MB,Dilallo M,Shau D,et al.Virtual reality as a learning tool for trainees in unicompartmental knee arthroplasty:A randomized controlled trial[J].J Am Acad Orthop Surg,2022,30(2):84-90.
[27]Vestermark GL,Bhowmik-Stoker M,Springer BD.Cognitive training for robotic arm-assisted unicompartmental knee arthroplasty through a surgical simulation mobile application[J].J Knee Surg,2019,32(10):984-988.
[28]Inzana JA,Varga P,Windolf M.Implicit modeling of screw threads for efficient finite element analysis of complex bone-implant systems[J].J Biomechanics,2016,49(9):1836-1844.
[29]Kang KT,Son J,Kwon SK,et al.Preservation of femoral and tibial coronal alignment to improve biomechanical effects of medial unicompartment knee arthroplasty:Computational study[J].Biomedical Materials Eng,2018,29(5):651-664.
[30]Kang KT,Kwon OR,Son J,et al.Effect of joint line preservation on mobile-type bearing unicompartmental knee arthroplasty:Finite element analysis[J].Australasian Physical Eng Sci Med,2018,41(1):201-208.
[31]Dai X,Fang J,Jiang L,et al.How does the inclination of the tibial component matter? A three-dimensional finite element analysis of medial mobile-bearing unicompartmental arthroplasty[J].The Knee,2018,25(3):434-444.
[32]Kwon HM,Kang KT,Kim JH,et al.Medial unicompartmental knee arthroplasty to patients with a ligamentous deficiency can cause biomechanically poor outcomes[J].Knee Surg Sport Traumatol Arthroscopy,2020,28(9):2846-2853.
[33]Kwon OR,Kang KT,Son J,et al.Importance of joint line preservation in unicompartmental knee arthroplasty:Finite element analysis[J].J Orthop Res,2017,35(2):347-352.
[34]Jones GG,Clarke S,Jaere M,et al.3D printing and unicompartmental knee arthroplasty[J].EFORT Open Reviews,2018,3(5):248-253.
[35]聂宇,樊宗庆.3D打印截骨导板辅助膝关节单髁置换近期临床疗效研究[J].中国矫形外科杂志,2018,26(1):84-86.
[36]Jaffry Z,Masjedi M,Clarke S,et al.Unicompartmental knee arthroplasties:Robot vs.patient specific instrumentation[J].Knee,2014,21(2):428-434.
[37]Ollivier M,Parratte S,Lunebourg A,et al.The John Insall Award:No functional benefit after unicompartmental knee arthroplasty performed with patient-specific instrumentation:A randomized trial[J].Clin Orthop Relat Res,2016,474(1):60-68.
[38]Demange MK,Von Keudell A,Probst C,et al.Patient-specific implants for lateral unicompartmental knee arthroplasty[J].Int Orthop,2015,39(8):1519-1526.
[39]Kang KT,Son J,Suh DS,et al.Patientspecific medial unicompartmental knee arthroplasty has a greater protective effect on articular cartilage in the lateral compartment:A finite element analysis[J].Bone Joint Res 2018,7(1):20-27.
[40]Carpenter DP,Holmberg RR,Quartulli MJ,et al.Tibial plateau coverage in UKA:A comparison of patient specific and off-the-shelf implants[J].J Arthroplasty,2014,29(9):1694-1698. |
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