全膝置换术假体周围骨量丢失的研究进展△（开放获取）

Research progress on periprosthetic bone mass losing after total knee arthroplasty (Open Access)

摘要:

全膝关节置换术（total knee arthroplasty, TKA）是膝关节相关疾病终末期的主要治疗方法。因此，膝关节假体是否松动已成为决定膝关节置换术后成败的决定性因素，假体周围骨量损失则成为重要的评价依据。此外，骨量丢失通常发生在膝关节置换术的早期，并且与假体的设计、手术技术、骨负荷状况以及功能锻炼有高度的相关性。尽管假体设计和手术技术不断进步，但 TKA 目前仍存在假体松动的高风险。本文对全膝关节置换术后应力传递机制、颗粒、炎症、假体周围骨量损失评估、 假体置入完成后修复标准等方面做一综述，以期为临床上假体松动的预防提供参考。

Abstract:

Total knee arthroplasty (TKA) is the main treatment for the end-stage knee diseases currently. However, whether the knee prosthesis is loose has become a decisive factor to determine the success or failure of the surgical procedure, and the bone loss around the prosthesis has become an important evaluation basis. In addition, bone mass loss usually occurs in early stage secondary to TKA, which is highly correlated with implant design, surgical technique, bone loading status, and functional exercise. Despite advances in implant design and surgical techniques, TKA is still at high risk of loosening the implant. In this paper, the stress transfer mechanism, particles, inflammation, evaluation of bone loss around the prosthesis, and repair criteria after prosthetic implantation were reviewed, so as to provide reference for the prevention of prosthetic loosening in clinical settings.