不同类型膝关节后稳定型假体髁间截骨量的对比

背景：后稳定型膝关节假体股骨侧需要额外的髁间截骨来容纳胫骨柱和股骨窝结构，髁间窝两侧与股骨体相连处应力集中是骨折好发部位。不同品牌假体不同型号间截骨量的差异并没有具体数据，不便于临床医生在选择假体时参考。 目的：比较临床上常用的后稳定型膝关节假体(进口、国产的6个品牌)髁间截骨数据的不同，为临床假体选择和应用提供依据。 方法：选择目前国内常用的(进口、国产的6个品牌)后稳定型人工膝关节假体，包括Zimmer NexGen LPS、Stryker Scrorpio NRG Knee-Flexed、Depuy PFC Sigma、Smith&nephew Genesis-2 PS、United-U1及威高GKPS。根据截骨模板确定截骨面包括股骨髁前截面、后截部、股骨髁远端截面、后斜截面；对应股骨假体径线包括髁内外径宽、髁前后径宽、股骨髁间窝截骨宽度及深度，对上述数据进行对比测量。 结果与结论：6种膝关节股骨髁假体的前后径/内外径、髁间窝截骨量及形态均存在差异，国外品牌股骨远端前后截骨面间径线较短，对后髁的截骨程度较大。随着应用假体尺寸的增大，所用品牌髁间截骨宽度所致骨量丢失比例均呈下降趋势，无论是小尺寸假体还是大尺寸假体，Stryker Scrorpio NRG Knee-Flexed假体髁间截骨宽度均较小。 6个品牌的膝关节假体截骨尺寸有所不同，以上结果并不足以评价不同假体之间的优劣，但就保留髁间骨储量而言，髁间截骨量少的设计较具优势。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Posterior stabilized knee prosthesis of different types: comparison of intercondylar osteotomy amount

BACKGROUND:Posterior stabilized femoral knee prosthesis needs additional condyle osteotomy to accommodate the tibial post and femur fossa structures. Intercondylar fossa on both sides connected at the femoral body with concentrated stress is a place easily affecting fractures. Differences in bone mass between different models of different brands did not have specific data, which was not convenient to select prosthesis for clinicians.  OBJECTIVE:To compare the difference of intercondylar osteotomy data among clinical commonly used   posterior stabilized knee prostheses (six imported and domestic brands), and to provide basis for the selection and application of the prostheses. METHODS:The current commonly used posterior stabilized knee prostheses (six imported and domestic brands) were used, including Zimmer NexGen LPS, Stryker Scrorpio NRG Knee-Flexed, Depuy PFC Sigma, Smith & nephew Genesis-2 PS, United-U1 and Wego GKPS. According to the osteotomy template, the osteotomy-surfaces consisting of femoral condyle starting section and cross section, distal section of femoral condyle, and back-oblique section were identified. The corresponding femoral prosthesis diameter lines included condylar ambilateral and anteroposterior diameters, width and depth of femoral intercondylar fossa. The above data were compared and measured. RESULTS AND CONCLUSION:The six kinds of knee femoral prostheses were different in ratio of ambilateral diameter and anteroposterior diameter, bone resection of intercondylar fossa, and geometry. Imported prostheses carry shorter diameters in femoral starting and cross sections, so it can catch more posterior condylar osteotomy. With increasing prosthesis sizes, the ratio of bone loss causing by width of intercondylar osteotomy is decreased among six brands. In all sizes, Stryker Scrorpio NRG Knee-Flexed catches shorter width of intercondylar osteotomy. Knee prosthesis osteotomy among six brands is different. The result of this study is not sufficient to evaluate the pros and cons between different prostheses, but as reserving bone is concerned, the design of less intercondylar osteoomy catches more advantages.