Ries Michael D
Department of Orthopedic Surgery, University of California, San Francisco, CA, USA.
Orthopedics. 2007 Aug;30(8 Suppl):74-6.
Total knee arthroplasty (TKA) is an effective treatment for arthritic knee pain, but patients may not return to their desired recreational or functional activity level post-TKA. The difference in functional outcome between patients who underwent TKA and patients with normal (nonarthritic) knees may be related to differences in kinematics between the normal and replaced knee. Posterior cruciate-retaining TKAs are associated with paradoxical motion in which the tibia is subluxed anteriorly in extension and the femur translates anteriorly during knee flexion. However, unicompartmental and patellofemoral arthroplasties, which retain the anterior cruciate ligament (ACL), however provide relatively normal knee kinematics and favorable knee function compared with conventional TKAs, which sacrifice the ACL. Early results with a bicruciate-substituting TKA suggest that ACL function is necessary to achieve more normal kinematics after TKA.
全膝关节置换术（TKA）是治疗膝关节炎疼痛的有效方法，但患者在TKA术后可能无法恢复到期望的娱乐或功能活动水平。接受TKA的患者与正常（非关节炎）膝关节患者之间功能结果的差异可能与正常膝关节和置换膝关节的运动学差异有关。后交叉韧带保留型TKA与反常运动相关，即胫骨在伸展时向前半脱位，股骨在膝关节屈曲时向前平移。然而，保留前交叉韧带（ACL）的单髁和髌股关节置换术与牺牲ACL的传统TKA相比，能提供相对正常的膝关节运动学和良好的膝关节功能。双交叉韧带置换型TKA的早期结果表明，ACL功能对于TKA术后实现更正常的运动学是必要的。
