Theory and practice of meniscal knee replacement: designing against wear.
Theory and practice of meniscal knee replacement: designing against wear.
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DOI：
10.1243/pime_proc_1996_210_415_02
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发表时间：
1996-01-01
期刊：
影响因子：
--
通讯作者：
Goodfellow, J W
中科院分区：
文献类型：
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作者：
O'Connor, J J;Goodfellow, J W
本文将高密度聚乙烯（HDP）在许多膝关节假体中的高磨损率归因于其关节面的不协调。作者讨论了膝关节的解剖学和运动学特征，这些特征导致大多数设计师选择不协调的表面，并回顾了采用自由关节面（类似于自然关节面）的原因，以提供一致性而不限制运动。在前交叉韧带（ACL）功能缺失的情况下，反对使用自由移动的关节面存在理论上的原因，作者的经验证实了实践中的这一局限性。结论是，在双间室置换术中，关节面的运动应限制在前后方向。对于单间室关节炎，如果所有韧带都完好无损，则可以使用非限制性关节面，这是通常的情况。
This paper attributes the high rate of high-density polyethylene (HDP) wear in many knee prostheses to incongruity of their articular surfaces. The authors discuss the anatomical and kinematic features of the knee which have led most designers to choose incongruous surfaces and review the reasons for employing free bearings, analogues of the natural menisci, to provide congruity without restriction of movement. There are theoretical reasons against employing freely mobile bearing in the absence of a functioning anterior cruciate ligament (ACL) and the authors' experience has confirmed this limitation in practice. It is concluded that, in bicompartmental replacement, the movements of the meniscal bearing should be limited in the anteroposterior direction. For unicompartmental arthritis, an unconstrained bearing can be employed if, as is usually the case, all ligaments are intact.