Fuchs Susanne, Skwara Adrian, Tibesku Carsten O, Rosenbaum Dieter
Orthopaedic Department, University Clinics Münster, Klinik und Poliklinik für Allgemeine Orthopädie, Albert-Schweitzer-Str. 33, D-48149 Münster, Germany.
Knee. 2005 Jan;12(1):9-12. doi: 10.1016/S0968-0160(02)00045-5.
Qualitative analysis of the retropatellar contact characteristics after total knee arthroplasty.
Six cadaveric knees were investigated before and after implantation of a Genesis I knee prosthesis without and with patellar resurfacing in different positions. Joint contact characteristics were evaluated with Fuji Prescale film type 'Super Low' and analyzed qualitatively in nine quadrants. The pressure was determined from a 5-s loading duration in four different knee positions between 45 degrees and 120 degrees of flexion. The femoral component of the prosthesis was implanted in neutral as well as in internal and external rotation. A quadriceps force of 280 N with either a predominant medial or lateral pulling direction was applied.
Without prosthesis the largest contact area is between 60 degrees and 90 degrees of flexion. A lateral muscle force direction as well as an external rotation increased the frequency of loading in the medial quadrants. After implantation of the prosthesis the central and superior quadrants were predominantly contacted irrespective of the flexion angle. No marked differences between the flexion angles were found. Implantation of the patellar resurfacing led to contact in the three central quadrants.
Implantation of the endoprosthesis leads to increased contact in slight and extreme flexion angles. Especially the central areas are increasingly loaded. No predominant influence of the rotation of the femoral component or the direction of the muscle pull was found. An improved distribution of the contact area could not be demonstrated after patellar resurfacing.
对全膝关节置换术后髌股关节接触特征进行定性分析。
研究6具尸体膝关节，在植入Genesis I膝关节假体前、后，分别在不同位置进行有无髌骨表面置换的情况。使用富士Prescale“超低”型薄膜评估关节接触特征，并在九个象限进行定性分析。在45度至120度屈曲之间的四个不同膝关节位置，通过5秒加载持续时间确定压力。假体的股骨部件分别以中立位以及内旋和外旋位植入。施加280 N的股四头肌力量，其牵拉方向以内侧或外侧为主。
未植入假体时，最大接触面积出现在60度至90度屈曲之间。外侧肌力方向以及外旋增加了内侧象限的加载频率。植入假体后，无论屈曲角度如何，中央和上方象限主要发生接触。未发现屈曲角度之间有明显差异。植入髌骨表面置换物导致三个中央象限发生接触。
植入假体导致在轻微和极度屈曲角度时接触增加。尤其是中央区域承受的负荷越来越大。未发现股骨部件旋转或肌肉牵拉方向有主要影响。髌骨表面置换后未显示接触面积分布得到改善。
