人工关节置换概述—培训课件.ppt

* femoral component and patella 股骨假体和髌骨 ?Ballanced“ patella “平衡”髌骨 Surgeons manual: most important steps 外科医生手册：最关键的步骤 ?instruments with a good alignement allow an accurate surgical technique !“ “ “器械良好的对线是手术技术精确的表现” femoral component and patella 人工全髋关节置换术 视频 人工关节置换术后并发症 感染 松动 脱位 术后疼痛 术后关节僵硬 假体周围骨折 金属过敏 炎性假瘤 * tibial plateau 胫骨平台 Shaped in accordance with the anatomy of the tibial head 解剖设计和胫骨平台良好匹配 Perfect coverage of the bone contact surface 完美覆盖骨接触表面 tibial plateau 胫骨平台 You avoid oversizing and any compromising of the popliteus muscle or dorsal capsule 避免过多处理或产生掴肌或背侧关节囊的任何妥协 tibial plateau tibial plateau polyethylene plateau 聚乙烯垫片 Dished surface provides congruency of the articulating planes 深盘状表面提供关节接触面的匹配 It stabilizes the knee joint even in absence of the PCL 即使在PCL缺如的情况下也能稳定膝关节 Large area of load transmission, less wear 大的应力传导面，磨损少 0 mm 4 mm 8 mm polyethylene plateau 聚乙烯垫片 In increasing flexion the femoral condyles glide backwards 增加屈膝时的后滚 polyethylene plateau 聚乙烯垫片 surgeons manual: ? …you can combine any size of femoral component with any size of tibial baseplate…“ 医生手册：“可以将任何型号的股骨假体和任何 型号的胫骨托进行匹配 uniform mechanism of fixation of the polyethylene, which must have the size of the femoral component 聚乙烯垫片的统一固定机制，需要和股骨假体型号进行匹配 polyethylene plateau聚乙烯垫片 Restriction 限制 ! combination of a smaler tibial baseplate to a femoral Component 胫骨托的型号不要小于股骨假体 polyethylene plateau is oversized ! 等于或大于没有问题 polyethylene plateau聚乙烯垫片 polyethylene plateau polyethylene plateau too much patello-femoral pressure or an incomplete tracking (?snapping“) of the patella causes anterior knee pain 太大的髌骨压力或不完全髌骨轨道 (?snapping“)会导致膝前痛 10 % after TKR TKR后10% femoral component and patella reduction of patello-femoral pressure 减少髌股压力 thin and high patellar glide 髌骨轨道又薄又长 anatomical shaped patellar groove 髌骨滑车解剖型设计 femoral component and patella reduction of patello-femoral pressure 减少髌-股压力 less invasive, ?ballanced“ approach is possible 微创，“平衡的”入路成为可能 backwa