全膝关节置换后关节线高度的研究进展

Research progress of joint line height changes in total knee arthroplasty

摘要:

全膝关节置换术（total knee arthroplasty, TKA） 后关节线高度改变可能造成膝关节屈伸活动受限，过度上移可导致膝关节屈曲过程中胫骨平台或垫片与髌骨下缘撞击，影响伸膝装置，增加髌股关节应力，引起屈曲受限及髌骨疼痛，甚至引起伸肌机制失效。目前关于关节线高度改变后的研究大多局限于理论，而有关临床研究相对较少，本文通过知网、Pubmed、SCI 检索库，回顾近年来国内外文献，从关节线高度的测量、生物力学研究、对临床功能的影响及其预防策略等方面对其进行综述，为临床外科医师提供理论参考，以改善临床功能，提高患者满意度。

Abstract:

The change of joint line height after total knee arthroplasty (TKA) may lead to the limitation of flexion and extension afteroperation. Excessive upward migration of joint line can lead to the impact of tibial plateau or spacer on the lower edge of patella duringknee flexion, which affects the knee extension device, increases the stress of patellofemoral joint, causes flexion limitation and patellarpain, even causes failure of the extensor mechanism. At present, most of the studies on the change of joint line height are theoretical, andthe clinical research is relatively less. This article reviews the domestic and foreign literature in recent years through the databases ofCNKI, Pubmed and SCI, and reviews the measurement of joint line height, biomechanical research, influence on clinical function and pre-vention strategies to provide theoretical reference for clinical surgeons, so as to improve the clinical function and patient's satisfaction.