Prosthesis chinzvimbo: UKA prosthesis Overhang ichaunza mhedzisiro ipi?

Unicompartmental knee arthroplasty (UKA) inzira yekuvhiya kune yakazara knee arthroplasty (TKA) yekurapa unicompartmental osteoarthritis. Zvisinei, data pamusoro pekukundikana kweUKA kunoratidza 7-gore yekurarama kwe74%, iyo yakanyanya kuderera kupfuura yeTKA (92%). Kunyange zvazvo zvikonzero zvevarwere pachavo zvinowedzera njodzi yekukundikana, zvakadai sevarwere vadiki uye yakakwirira body mass index (BMI) inogona kuwedzera njodzi yekukundikana kweUKA, zvikanganiso zvekuvhiya zvehunyanzvi zvakaonekwa sezvikonzero zvakakosha zvekutadza kwekutanga. MuUKA, zvinonetsa kuwana yakakwana prosthetic alignment uye overhang (overhang). Iyo tibial prosthesis inofanira kunge yakakura uye yakasimwa nenzira inoderedza kutsamwiswa kwezvinyoro zvinyoro, uye kuputika kwepakati kwepakati kwepamusoro pe3 mm kwakaratidzwa kuva chinhu chikuru chengozi yekuderera kweOxford Knee Score (OKS) uye kuwedzera kurwadziwa. Chinangwa chikuru chechidzidzo ichi chaive chekuongorora mhedzisiro yekiriniki nekufungidzira yeUKA. Chinangwa chechipiri chaive chekuongorora mhedzisiro yeprosthetic malalignment uye overhang pane implant survival.Unicompartmental knee arthroplasty (UKA) inzira yekuvhiya kune yakazara knee arthroplasty (TKA) yekurapa unicompartmental osteoarthritis. Zvisinei, data pamusoro pekukundikana kweUKA kunoratidza 7-gore yekurarama kwe74%, iyo yakanyanya kuderera kupfuura yeTKA (92%). Kunyange zvazvo zvikonzero zvevarwere pachavo zvinowedzera njodzi yekukundikana, zvakadai sevarwere vadiki uye yakakwirira body mass index (BMI) inogona kuwedzera njodzi yekukundikana kweUKA, zvikanganiso zvekuvhiya zvehunyanzvi zvakaonekwa sezvikonzero zvakakosha zvekutadza kwekutanga. MuUKA, zvinonetsa kuwana yakakwana prosthetic alignment uye overhang (overhang). Iyo tibial prosthesis inofanira kunge yakakura uye yakasimwa nenzira inoderedza kutsamwiswa kwezvinyoro zvinyoro, uye kuputika kwepakati kwepakati kwepamusoro pe3 mm kwakaratidzwa kuva chinhu chikuru chengozi yekuderera kweOxford Knee Score (OKS) uye kuwedzera kurwadziwa. Chinangwa chikuru chechidzidzo ichi chaive chekuongorora mhedzisiro yekiriniki nekufungidzira yeUKA. Chinangwa chechipiri chaive chekuongorora mhedzisiro yeprosthetic malalignment uye overhang pane implant kupona.

Nzira

Ichi chidzidzo chaive chidzidzo chepakati-chete chaisanganisira varwere vevarume nevakadzi vakagamuchira UKA yepakati pachikwata chedu kubva munaJanuary 2008 kusvika kuDecember 2017, uye varwere vose vakawana UKA vachishandisa nzira dzakagadziriswa.Kusabatanidzwa kweUKA kwaisanganisira kuderera kusvika kune zvakanyanya valgus deformity, patellofemoral compartment arthritis, posterior tibial displacement, uye kusagadzikana. Migumisiro yemakiriniki uye yekufungidzira yakawanikwa kubva pakuongorora kwekare kwekliniki zvinyorwa uye zvinyorwa zvemasangano. Femoral coronal uye sagittal angles (FCA neFSA) uye tibial coronal uye sagittal angles (TCA neTSA) akayerwa pamaradiographs kune ese akagadziriswa-chikuva uye chinofambiswa-chikuva UKAs, sezvakaratidzwa.

Mhedzisiro

Iyo yekutevera yekutevera yaive makore 4.9 (0.03 kusvika 10.2 makore). Takaona 36 kudzokorora kuvhiyiwa nechinangwa chemakore 3.7 (0.03 kusvika kumakore 8.7) mushure mekushanda uye kuwedzera kwekukundikana kwe14.2%. Kupona kwemakore mashanu kwaive 88.0% (95% nguva yekuvimba [CI] = 82.0% kusvika 91.0%) uye makore gumi ekurarama aive 70.0% (95% CI = 56.0% kusvika 80.0%).

Zvikonzero zvakajairika zvekudzokorora zvaive zvakashata / kusagadzikana prosthesis alignment (31%), kukanganisa kwemagetsi (22%), kufambira mberi kweasteoarthritis (14%), uye kurwadziwa kusinganzwisisiki (8%).

Chete 11.9% yeUKAs yakawana zvese zvaidiwa kurongeka uye kufukidzwa kweprosthetic. Anterior overhang of the prosthesis yakanga isiri ngozi inokosha yekukundikana kweUKA (10.0% kukundikana kwehuwandu, p = 0.090), uye posterior overhang ye prosthesis (25.0%, p = 0.006) uye kupindira kwepakati kweprosthesis (38.2%, p <0.001) kwaiva kukanganisa kukuru kweUKA.

Kurukurai

Muchidzidzo ichi, takaongorora mhedzisiro yekiriniki uye yekufungidzira ye medial UKA uye kukanganisa kweprosthetic alignment uye overhang. 5- uye 10-yemakore ekupona mazinga aiva 88% uye 70%, maererano, uye akanga akaderera zvikuru pane TKA. zviratidzo zvakajairika zvekudzokorora zvaive zvisina kunaka prosthetic alignment, mechanical failure, uye kufambira mberi kweosteoarthritis. Yakashata prosthesis alignment uye posterior uye medial overhang zvinhu zvakakosha zvengozi yeUKA kudzokorora.

Muzvinyorwa zvakaburitswa, izvo zviviri zvinokonzeresa kutadza kweUKA ndezvekuregedza kweaseptic uye kufambira mberi kweosteoarthritic, ese ane kusaenzana kwemutoro wekugovera, zvichiratidza kuti zvikonzero zvataurwa pamusoro zvekutadza kweUKA zvinogona kunge zviri zvemuchina. Humbowo uhwu hunoratidza kuti kurongeka kweprosthesis kunogona kukonzera kutadza kweUKA. Naizvozvo, isu tinotenda kuti kuedza kunofanirwa kuitwa kuvandudza nzira dzekuvhiya kuvandudza UKA prosthesis alignment uye kuderedza kuitika kwekuwedzeredza.

Zvakawanikwa iye zvino zvinoratidza kuti kushamwaridzana kwakasimba pakati pekushaya prosthesis alignment / overhang uye njodzi yekudzokorora inoratidza nzira inogona kuitika yehuwandu hwekukundikana hunoonekwa muchidzidzo ichi. Kugona kwechiremba wekuvhiya kuve akarurama nguva dzose mukuiswa kweprosthesis chinhu chakakosha mukubatsira kuvandudza mararamiro eUKA.

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