Ishii Yoshinori, Matsuda Yoshikazu, Ishii Ryo, Sakata Shigeo, Omori Go
Ishii Orthopaedic and Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, 361-0037, Japan.
J Orthop Sci. 2003;8(4):538-42. doi: 10.1007/s00776-003-0668-0.
We performed stress arthrometric studies on 77 knees (71 patients) with total knee arthroplasty to determine the presence and magnitude of femoral abduction and adduction in knee extension. A total of 53 knees (49 patients) had posterior cruciate ligament-retaining (PCLR) prostheses, and 24 (22 patients) had PCL-substituting (PCLS) prostheses. The selected patients had successful arthroplasties with no clinical complications a minimum of 5 years after primary surgery. Each patient was subjected to a successive abduction and adduction stress test at 0 degrees -20 degrees of flexion using a Telos arthrometer. The mean values for abduction and adduction were 4.8 degrees and 4.5 degrees with a PCLR prosthesis, respectively, and 4.6 degrees and 4.0 degrees with a PCLS prosthesis. There were no statistical differences between PCLR and PCLS knees. The results suggest that approximately 4 degrees of laxity in these directions is suitable in total knee arthroplasty for a satisfactory clinical outcome 5-9 years after surgery.
我们对77个膝关节(71例患者)进行了全膝关节置换术后的应力关节测量研究,以确定膝关节伸展时股骨外展和内收的存在情况及程度。其中53个膝关节(49例患者)采用了保留后交叉韧带(PCLR)的假体,24个膝关节(22例患者)采用了后交叉韧带替代(PCLS)的假体。所选患者初次手术后至少5年关节置换成功且无临床并发症。使用Telos关节测量仪对每位患者在0度至20度屈曲时依次进行外展和内收应力测试。PCLR假体的外展和内收平均值分别为4.8度和4.5度,PCLS假体的外展和内收平均值分别为4.6度和4.0度。PCLR膝关节和PCLS膝关节之间无统计学差异。结果表明,在这些方向上约4度的松弛度在全膝关节置换术中是合适的,可在术后5至9年获得满意的临床结果。