Longstaff Lee M, Sloan Karen, Stamp Nikki, Scaddan Matt, Beaver Richard
Department of Elective Orthopaedics, Royal Perth Hospital, Perth, Australia.
J Arthroplasty. 2009 Jun;24(4):570-8. doi: 10.1016/j.arth.2008.03.002. Epub 2008 May 19.
The aim of this study was to identify what aspects of implant alignment and rotation affect functional outcome after total knee arthroplasty (TKA). One hundred and fifty-nine total knee arthroplasties were performed at the authors' institution between May 2003 and July 2004. All patients underwent an objective and independent clinical and radiological assessment before and after surgery. A computed tomography scan was performed at 6 months. The alignment parameters that were measured included sagittal femoral, coronal femoral, rotational femoral, sagittal tibial, coronal tibial, and femorotibial mismatch. The cumulative error score, which represents the sum of the individual errors, was calculated. Functional outcome was measured using the Knee Society Score. Good coronal femoral alignment was associated with better function at 1 year (P = .013). Trends were identified for better function with good sagittal and rotational femoral alignment and good sagittal and coronal tibial alignment. Patients with a low cumulative error score had a better functional outcome (P = .015). These patients rehabilitated more quickly and their length of stay in hospital was 2 days shorter.
本研究的目的是确定全膝关节置换术（TKA）后植入物的对线和旋转的哪些方面会影响功能结果。2003年5月至2004年7月期间，作者所在机构共进行了159例全膝关节置换术。所有患者在手术前后均接受了客观、独立的临床和影像学评估。术后6个月进行了计算机断层扫描。测量的对线参数包括股骨矢状位、股骨冠状位、股骨旋转、胫骨矢状位、胫骨冠状位和股胫不匹配。计算了代表个体误差总和的累积误差评分。使用膝关节协会评分来衡量功能结果。良好的股骨冠状面对线与1年时更好的功能相关（P = 0.013）。已发现股骨矢状位和旋转位以及胫骨矢状位和冠状位对线良好时功能有改善趋势。累积误差评分低的患者功能结果更好（P = 0.015）。这些患者康复更快，住院时间缩短2天。
