Sugama Ryo, Kadoya Yoshinori, Kobayashi Akio, Takaoka Kunio
Department of Orthopaedic Surgery, Osaka City University Medical School, Osaka City, Osaka, Japan.
J Arthroplasty. 2005 Aug;20(5):602-7. doi: 10.1016/j.arth.2003.12.085.
Changes in the extension gap caused by the preparation of the flexion gap were measured in 50 varus osteoarthritic knees undergoing total knee arthroplasty. The extension gap was first prepared and then measured before and after preparation of the flexion gap. The extension gap increased significantly on both the medial and lateral sides (19.3 +/- 0.3 to 22.0 +/- 0.3 and 21.9 +/- 0.3 to 24.0 +/- 0.3 mm, respectively, mean +/- SE, both P < .0001). The increase was greater medially (P = .0014), and in the knees with more varus deformities (> or = 10 degrees, P = .0075). Thus, preparation of the flexion gap resulted in significant widening of the extension gap, especially on the medial side. The medial release should be stepwise and conservative to achieve adequate soft tissue balance.
在50例接受全膝关节置换术的内翻型骨关节炎膝关节中，测量了由屈膝间隙准备导致的伸直间隙变化。首先准备伸直间隙，然后在屈膝间隙准备前后进行测量。内侧和外侧的伸直间隙均显著增加（分别从19.3±0.3变为22.0±0.3以及从21.9±0.3变为24.0±0.3mm，均值±标准误，P均＜0.0001）。内侧增加幅度更大（P = 0.0014），并且在伴有更严重内翻畸形（≥10度，P = 0.0075）的膝关节中也是如此。因此，屈膝间隙的准备导致伸直间隙显著增宽，尤其是在内侧。内侧松解应逐步且保守地进行，以实现充分的软组织平衡。
