【摘要】 单髁膝关节置换术（UKA）中假体的手术安装精度是影响术后膝关节功能和假体寿命的重要因素。本文以UKA股骨部件相对胫骨衬垫内外侧位置的比值（a/A）为参数，分别考虑了9种不同股骨部件安装情况，建立UKA置换的骨肌多体动力学模型并模拟患者术后行走步态，研究UKA手术中股骨部件内外侧安装位置对术后膝关节接触力、关节运动和韧带力的影响。结果表明，随着a/A比值的增大，膝关节内侧假体接触力减小，外侧软骨接触力增大；膝关节内翻运动、外旋运动和关节后移运动增大；前交叉韧带力、后交叉韧带力和内侧副韧带力减小。UKA股骨部件内外侧安装位置对膝关节屈曲伸展运动、外侧副韧带力影响不大。而当a/A≤0.375时，股骨部件与胫骨会产生接触。为了避免内侧假体和外侧软骨承受过高的载荷、产生过高的韧带力以及内侧假体与胫骨碰撞等问题，本文建议医生UKA手术中安装股骨部件时a/A比值控制在0.427～0.688范围内，为UKA手术中股骨部件内外侧安装提供了参考依据。更多还原

【Abstract】 The surgical installation accuracy of the components in unicompartmental knee arthroplasty(UKA) is an important factor affecting the joint function and the implant life. Taking the ratio of the medial-lateral position of the femoral component relative to the tibial insert(a/A) as a parameter, and considering nine installation conditions of the femoral component, this study established the musculoskeletal multibody dynamics models of UKA to simulate the patients’ walking gait, and investigated the influences of the medial-lateral installation positions of the femoral component in UKA on the contact force, joint motion and ligament force of the knee joint. The results showed that, with the increase of a/A ratio, the medial contact force of the UKA implant was decreased and the lateral contact force of the cartilage was increased; the varus rotation, external rotation and posterior translation of the knee joint were increased; and the anterior cruciate ligament force, posterior cruciate ligament force and medial collateral ligament force were decreased.The medial-lateral installation positions of the femoral component in UKA had little effect on knee flexion-extension movement and lateral collateral ligament force. When the a/A ratio was less than or equalled to 0.375, the femoral component collided with the tibia. In order to prevent the overload on the medial implant and lateral cartilage, the excessive ligament force, and the collision between the femoral component and the tibia, it is suggested that the a/A ratio should be controlled within the range of 0.427-0.688 when the femoral component is installed in UKA. This study provides a reference for the accurate installation of the femoral component in UKA.更多还原