全膝关节置换术中下肢对线的研究现状

众所周知,全膝关节置换术( TKA) 是治疗终末期退行性膝骨关节疾病最有效的手术方式。传统认为精确地矫正下肢力线是重要的目标,它影响着关节稳定的维持和关节功能的恢复。随着膝关节假体设计、手术方式的发展,以及机器人辅助系统及计算机导航系统在TKA中应用,TKA对准较前更加精确,但TKA术后临床效果却并未明显提升,且仍有将近20%TKA术后患者对自己的手术表示不满意。究其因素,许多骨科医生认为普遍使用传统的机械轴对线技术可能是因素之一,探讨何种下肢力线技术才是最理想的选择。基于此,本文阐述的内容和TKA中的下肢对线有关,涉及运动学、机械轴、功能性及解剖轴等对线,目的是在 TKA 中为骨科医师针对不同的下肢力线选择合适的对线方案提供参考。

Research status of lower limb alignment in total knee arthroplasty

It is well known that total knee arthroplasty (TKA) is the most effective surgical treatment for end-stage degenerative knee osteoarthrosis.STraditionally, it is considered that accurate correction of lower limb alignment is an important goal, which affects the maintenance of joint stability and the recovery of joint function.With the development of knee prosthesis design, surgical methods, and the application of robot-assisted system and computer navigation system in TKA, the alignment of TKA is more accurate than before, but the clinical effect after TKA is not significantly improved, and nearly 20% of patients after TKA are still dissatisfied with their surgery. Looking for the cause,many orthopedic surgeons believe that the widespread use of traditional mechanical alignment technique may be one of the factors, to explore which lower limb alignment technique is the most ideal choice. Therefore, this article reviews the current lower limb alignment techniques in TKA, including mechanical alignment, kinematic alignment, anatomical alignment, functional alignment, etc., in order to provide a reference for orthopedic surgeons to select different lower limb alignment alignment schemes in TKA.