Shakespeare David, Ledger Michael, Kinzel Vera
Department of Orthopaedics, Warwick Hospital, Lakin Road, Warwick, UK.
Knee. 2005 Dec;12(6):405-9. doi: 10.1016/j.knee.2005.03.003. Epub 2005 Jun 24.
Screened postoperative X-rays of 224 Oxford knees implanted through the minimally invasive approach were analysed using 16 criteria. The technique was as recommended by the Oxford Group except that the femoral intramedullary rod was used only as a guide to flexion/extension of the femoral component. All femoral components were within the recommended range for varus/valgus and mediolateral position. Eighteen femoral components were either too flexed or extended, but by a maximum of only 10 degrees . Tibial components were inserted in slight varus (mean 1.8 degrees , S.D. 8.8, range 10 to -10). All were within the range for posterior slope in spite of difficulty in establishing objective landmarks. Tibial coverage was imprecise with the phase 3 implants which were short and broad relative to the cut surface. In 36% of knees the tibial tray was implanted too anterior resulting in posterior under hang. There have been no clinical signs to indicate tipping of the meniscus in deep flexion. The depth of cement penetration under the keel was excessive in three cases, resulting from porotic bone rather than technical error in the depth of the cut. There has been one case of femoral component loosening following a fall and no tibial loosening in spite of imprecise alignment of some components.
对224例采用微创入路植入的牛津膝关节术后X线片进行分析，共使用16项标准。该技术按照牛津小组的建议进行，只是股骨髓内杆仅用作股骨部件屈伸的导向。所有股骨部件的内翻/外翻及内外侧位置均在推荐范围内。18个股骨部件存在过度屈曲或伸展，但最大仅为10度。胫骨部件以轻度内翻方式植入（平均1.8度，标准差8.8，范围为10至-10）。尽管难以确定客观标志，但所有部件的后倾角度均在范围内。相对于切割面，第3代植入物短而宽，导致胫骨覆盖不准确。在36%的膝关节中，胫骨托植入过于靠前，导致后方悬垂不足。在深度屈曲时，没有临床迹象表明半月板有倾斜。3例病例中，由于骨疏松而非切割深度的技术失误，导致龙骨下方骨水泥渗透过深。有1例股骨部件在跌倒后出现松动，尽管部分部件对线不准确，但没有胫骨松动的情况。
