Artificial Knee: Theoretical Basis and Clinical Application

Author: Wang Wenyuan (Compiler)
Publisher:
Publishing Date: 2004-05-01
Features: Over the years, artificial knee joints have seen significant advancements in model design, component interchangeability, surgical instruments, and surgical techniques. The excellent surgical outcomes and high survival rates of artificial knees are truly encouraging. A survival rate exceeding 10 years can now serve as a standard for evaluating long-term positive effects. China has entered an aging society. According to domestic publications in 2001, 80% of individuals aged 65 and above suffer from osteoarthritis. It is estimated that there are 2 million people in China who meet the criteria for artificial knee replacement but have not yet undergone the surgery (People's Daily Overseas Edition, July 9, 2001). In 2002, artificial knee replacement surgeries worldwide were estimated to exceed 600,000 annually (Stiehl, 2002). Based on this ratio, the aforementioned domestic estimates may be conservative. The goal of artificial knee replacement is to restore patients to a pain-free, functionally sound, durable, and long-lasting knee, thereby fundamentally improving their quality of life and enabling them to maintain self-sufficiency even in old age. This is undoubtedly of great practical significance for China, which is entering an aging society. This book briefly introduces the history of artificial knee development, the important anatomical and physiological characteristics of natural knees, as well as the fundamental principles of artificial knee biomechanics, market in Europe and America, major representative models, surgical principles and key points, complications, and postoperative rehabilitation. It aims to provide some references for orthopedic colleagues, artificial knee design professionals, related computer workers, and medical staff responsible for preoperative, intraoperative, and postoperative care in clinical artificial knee replacement surgeries and research. Currently, in clinical applications in Europe and America, surface condyle-type artificial knees hold a significant position, and this book dedicates considerable to describing them. Through long-term follow-up of a large number of cases, people have found that the performance of new axis-chain tight artificial knees is not inferior to that of surface condyle-type artificial knees. Due to the stability they provide and the relatively simple surgical techniques and instruments, the latter has irreplaceable advantages over the surface condyle type. Since artificial knee replacement surgery has not yet been widely conducted in China, there are still many older patients with severely damaged, deformed, and unstable knees due to osteoarthritis or rheumatoid arthritis who need treatment. In this context, the new axis-chain artificial knee, represented by the Blauth-type artificial knee (Aesculap Company, Germany), has a specific scope of application and cannot be overlooked. The author of this book has been away from his homeland for over 20 years and lacks comprehensive knowledge of domestic data. Through preliminary research, it has been found that colleagues in Beijing, Shanghai, and other cities have achieved encouraging results and outcomes in artificial knee work. However, given the large number of patients in various parts of China who need artificial knee replacement, there is clearly still much work to be done. The development of artificial knees is still in its early stages, and it is entirely possible to see new design theories, models, materials, and technologies emerge. Chapter 10 of this book introduces the development of computer navigation and robotic-assisted artificial knee replacement. With the rapid progress of gene biotechnology and stem cell research, the use of cloned autologous joints to replace diseased or damaged joints to avoid the immune rejection of allogeneic or xenogeneic joints, the foreign body reaction of heterologous artificial joints, or the wear of heterologous materials, and even achieving breakthroughs in the prevention and treatment of joint degenerative diseases, is theoretically not impossible. However, in practical applications, issues such as ethical debates, government and societal acceptance, application technology, unforeseen defects, complications, and high costs still need to be addressed. It is certain that there is still a long way to go. It can be expected that in the next 10 years or even decades, further improvements in artificial knees will be made to provide more practical artificial knees for the majority of patients with severely damaged, functionally impaired, and painful knees, alleviating their urgent suffering. It is well known that artificial knee replacement surgery has higher sterility requirements than general orthopedic surgery, and ordinary operating room conditions are not sufficient. Further research on artificial knees, gradual domestication, cost reduction, and reduced medical expenses are all practical issues that need to be addressed in the promotion of artificial knee surgery in China.