Barink M, Van de Groes S, Verdonschot N, De Waal Malefijt M
Orthopaedic Research Lab, Department of Orthopaedics, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
J Biomech. 2006;39(9):1708-15. doi: 10.1016/j.jbiomech.2005.04.027. Epub 2005 Jun 24.
The patella groove of total knee replacements has evolved from a groove with a neutral orientation to a groove with a lateral (also referred to as valgus) orientation. In this study the authors questioned whether femoral components with a lateral groove orientation more closely approximate the configuration in the natural knee. The groove orientations of an implanted CKS femoral component, available in different sizes and with different groove orientations, were determined and compared with formerly published measurements of the natural trochlear orientation. It was found that the prosthetic groove orientations differed considerably from human anatomy, up to a maximum deviation of 6.4 degrees. The orientations of the prosthetic grooves were all equal within the area of the natural trochlea. The area of the natural trochlea guides the patella between about 30 degrees and 120 degrees of knee flexion. The orientations of the prosthetic grooves were different in the area of the supracondylar pouch/proximal anterior flange. This area guides the patella between about 0 degrees and 30 degrees of knee flexion. As this study showed a considerable deviation between natural and prosthetic groove orientation, an optimal prosthetic groove orientation, matching the average orientation in the natural knee, was mathematically determined.
全膝关节置换术的髌骨沟已从具有中立方向的沟演变为具有外侧（也称为外翻）方向的沟。在本研究中，作者质疑具有外侧沟方向的股骨组件是否更接近自然膝关节的形态。确定了不同尺寸和不同沟方向的植入式CKS股骨组件的沟方向，并与先前发表的自然滑车方向测量值进行比较。结果发现，假体沟方向与人体解剖结构有很大差异，最大偏差达6.4度。在自然滑车区域内，假体沟的方向都是相同的。自然滑车区域在膝关节屈曲约30度至120度之间引导髌骨。在髁上袋/近端前凸缘区域，假体沟的方向不同。该区域在膝关节屈曲约0度至30度之间引导髌骨。由于本研究显示自然沟和假体沟方向之间存在相当大的偏差，因此通过数学方法确定了与自然膝关节平均方向相匹配的最佳假体沟方向。
