2022 年第 6 期 第 17 卷

全膝关节置换术的手术入路研究进展

Research progress on the approach of total knee arthroplasty

作者：黄梁坤彭昊

英文作者：Huang Liangkun Peng Hao

单位：武汉大学人民医院骨Ⅱ科，武汉430060

英文单位：Department of Orthopedics Ⅱ Renmin Hospital of Wuhan University Wuhan 430060 China

关键词：全膝关节置换术；骨关节炎；膝关节疾病；髌旁内侧入路

英文关键词：Totalkneearthroplasty;Osteoarthritis;Kneejointdisease;Medialparapatellarapproach

• 摘要：

• 工全膝关节置换术(TKA)为终末期膝关节疾病的常见治疗方法。髌旁内侧入路是TKA有效且安全的主流入路，其难度小、术野暴露良好，可最大限度减少假体对位不准等并发症，但其对股四头肌损伤较大，患者术后恢复慢。目前可替代的TKA入路还有髌旁外侧入路、股内侧肌中间入路、股内侧肌下入路和微创入路等，不同手术入路有其各自的适应证和优缺点，在TKA入路选择上应结合手术医师的经验和患者的个体特征。本文对现阶段TKA各种手术入路的方法和临床应用进展进行综述。

• Total knee arthroplasty (TKA) is a common treatment for end-stage knee diseases. Medial parapatellar approach (MPA) is an effective and safe mainstream approach for TKA. MPA has low difficulty and good exposure of the operation field. It can minimize the complications such as incorrect alignment of the prosthesis, but it has great damage to the quadriceps femoris and slow postoperative recovery. At present, the alternative approaches for TKA include lateral parapatellar approach, medial femoral muscle intermediate approach, medial femoral muscle subapproach and minimally invasive approach. Different surgical approaches have their own indications, advantages and disadvantages. The selection of TKA approach should be combined with the experience of surgeons and the individual characteristics of patients. This paper reviews the methods and clinical application of various surgical approaches of TKA at the present stage.