中醫(yī)-advance產品概覽

Advance?

內軸型膝關節(jié)系統(tǒng)

歷史以及設計線路1998199920002001200220032004200520062007Advance?

CCKKneeSystemaMP?Advance?內軸膝型膝關節(jié)系統(tǒng)ADVANCESTATURE?KneeSystem20082009Advance?StemmedKneeSystemAdvance?TibialOffsetTraysADVANCE?BIOFOAM?TibialTrays2010

仿生理設計

穩(wěn)定性高

恢復自然膝運動方式

低磨損設計1.Blahaetal,JBJSAm2002;84-ASuppl2:48-552.VanDuren,JournalofBiomechanics40(2007):S31-S373.Komisteck,CORR410,2003:114-1304.Minoda,CORR410,2003:165-172aMP?KneeSystem股骨髁股骨無髁間截骨設計6個型號(LeftandRight)鈷鉻鉬(CoCrMo)合金材質內表面:噴砂股骨后髁截骨量少，更多骨保留ABCCSIZEABC160528265578370628475668580718685769運動學分析表明，自然膝股骨相對于脛骨圍繞一個恒定的軸運動。這個軸與遠端和后髁之間的距離幾乎相等5.Blahaetal,JBJSAm2002;84-ASuppl2:48-55從解剖學……到產品自然膝解剖幾何學的重現(xiàn)aMP?KneeSystem仿生理設計R2<R1較小的閉合半徑來增加活動度0°90°R1R1R1Medial內側Lateral外側R26.Iwakietal,JBJS82-B,n°8(2000):1189-95aMP?KneeSystem屈曲穩(wěn)當性InternalData體積/立方英寸aMP?KneeSystem更多骨保留股骨內側上方壓痕設計，有利于過伸，同時減少在過伸運動時的疼痛和撞擊風險前參考設計，不同型號假體立柱到前髁距離恒定，在選小號時，后髁截骨量增加，前髁截骨量不變7.Pinskerovaetal“Theshapesandrelativemovementsofthefemurandtibiaintheunloadedcadavericknee:astudyusingMRIasananatomictool”JBJS82-B,(2000)aMP?KneeSystem獨特設計理念從伸直到屈曲90度，髕骨軌跡也是一個恒定的單半徑運動，和股骨髁單半徑設計一致更深的滑車槽設計保證更安全穩(wěn)定的髕骨關節(jié)運動8.2010DanishKneeArthroplastyRegistryaMP?KneeSystem更友好的髕骨關節(jié)運動9.Andersonetal“Patellofemoralcomplicationsafterposterior-stabilizedtotalkneearthroplasty”JoA17,4,2002更后延伸的滑車溝，在高屈曲時提供與髕骨的更安全接觸區(qū)與PS型股骨髁設計相比，髕股并發(fā)癥明顯減少。aMP?KneeSystem更友好的髕骨關節(jié)運動3.6°向外的滑車槽設計

最大限度的減少外側韌帶的張力

減少外側韌帶、軟組織的松解10.Eckhoff“Locationofthefemoralsulcusintheosteoarthriticknee”TheJournalofArthroplasty11:163,1996aMP?KneeSystem更友好的髕骨關節(jié)運動防止半脫位半屈曲狀態(tài)時維持髕股軌跡正常11.Internaldata12.Kujalaetal“Patellofemoralrelationshipinrecurrentpatellardislocation”JBJS71B:788,19896°前傾6度設計避免股骨前方切跡aMP?KneeSystem前后徑適合的標準假體有可能內外徑不適合，導致假體懸掛現(xiàn)象

13.PoilvachePL.ClinOrthopRelatRes.1996;331:35-4614.HittK.JBoneJointSurg.2003;85-A:115-22aMP?KneeSystemSTATURE?亞洲髁SIZEABC1605282-ADVANCESTATURE?605782655783-ADVANCESTATURE?656283706284-ADVANCESTATURE?70668475668580718685769同型號股骨假體的寬度減少5mm，同時髕股軌跡一致ABCCStandardADVANCE?

FemoralComponentADVANCESTATURE?

FemoralComponentaMP?KneeSystemSTATURE?

亞洲髁后叉韌帶犧牲型設計6個型號(LeftandRight)超高分子聚乙烯材質內側球窩設計外側凹槽設計MLaMP?KneeSystem墊片內側髁與球窩高度匹配外側髁更少的限制性內側髁的球窩高度匹配外側圍繞內側15度旋轉aMP?KneeSystem仿生墊片設計墊片前唇增高11毫米垂直脫位距離23-32mm(視尺寸而定)水平脫位距離。更長的脫位距離減少屈曲時的股骨髁前滑15.Komisteck,CORR410,2003:114-130aMP?KneeSystem墊片-更少脫位aMP?KneeSystemPSKneeSystem16.Barteletal“Theeffectofconformity,thicknessandmaterialonstressesinUHMWPEcomponentsfortotaljointreplacement”JBJS68A:7,1986聚乙烯墊片磨損導致的骨溶解是導致全膝關節(jié)置換術失敗的主要原因之一藕合的表面材料墊片的厚度假體設計理念ContactAreaStressesWearaMP?KneeSystem磨損從伸直到屈曲，Advance股骨髁與墊片接觸面積最大aMP?KneeSystem磨損–接觸面積ContactArea[mm2]Flexion[°]17.InternalData18.S.G.Elias,M.D.,M.A.R.Freeman,M.D.,F.R.C.S.,andE.I.Gokcay,M.D.:ACorrelativeStudyoftheGeometryandAnatomyoftheDistalFemur.ClinicalOrthopedicsandRelatedResearch:260,1990.17.InternalDataaMP?KneeSystem磨損–接觸面積aMP?KneeSystemJ-curvePSKneeSystemContactArea[mm2]Flexion[°]超高分子聚乙烯vs高交聯(lián)聚乙烯在TKA仍有爭議交聯(lián)處理減少了磨損，但降低了材料的力學性能，產生了更小的顆粒MicroPort的超高分子聚乙烯制造(GUR1020)和消毒(EtO)提供高性能19.Costa,BrachdelPrever,“UHMWPEforarthroplasty”Torino,Italy2000,EdMinervaMedica20.FisherJetal"Wear,debris,andbiologicactivityofcross-linkedpolyethyleneintheknee:benefitsandpotentialconcerns”ClinOrthopRelatRes.2004Nov;(428):114-9

aMP?KneeSystem磨損----材料WearRate21-24[mm3/Mc]21.McEwenetal,JBiomech2005;38:357-6522.Schwenkeetal,Wear2009;267:757-62Disclaimer:Datapresentedarecollectedfrompublications-notallthevariablescanbeaccountedforandtheymighthaveaneffectondatacomparison23Haideretal,ORSPoster2002;27:100724.Muratogluetal,CORR2004;428:117-9aMP?KneeSystem磨損比較6標準尺寸and5PLUS尺寸CoCrMo合金表面磨砂處理aMP?KneeSystem脛骨部分TRAYSIZEABC16041351+65443526544352+70484337048433+75514347551434+80545058054505+8558506855850示例：脛骨托3+與脛骨托4號的尺寸相同股骨髁3與脛骨托3/3+配伍FEMURINSERTTIBIALTRAY111or1+222or2+333or3+444or4+555or5+666ACB3TRAY3+TRAYaMP?KneeSystem脛骨部分燕尾鎖定機制定位標記Size1Size635mm50mmKeellengthincreaseswithsizeaMP?