Cates Hal E, Komistek Richard D, Mahfouz Mohamed R, Schmidt Monica A, Anderle Matthew
College of Engineering, Center for Musculoskeletal Research, University of Tennessee, Knoxville, Tennessee 37996, USA.
J Arthroplasty. 2008 Oct;23(7):1057-67. doi: 10.1016/j.arth.2007.09.019. Epub 2008 Mar 14.
The objective of this study was to determine the in vivo kinematics for subjects having either a fixed posterior stabilized (PS) or cruciate retaining (CR) high-flexion total knee arthroplasty (TKA). Three-dimensional kinematics from full extension to maximum flexion were determined for 30 subjects (15 PS, 15 CR) using fluoroscopy. On average, the PS subjects demonstrated 112 degrees of weight-bearing (WB) flexion, -6.4 mm of posterior femoral rollback, and 2.9 degrees of axial rotation. The CR subjects averaged 117 degrees of WB flexion, -4.9 mm of posterior femoral rollback, and 4.8 degrees of axial rotation. Posterior femoral rollback of the lateral condyle occurred for all PS TKAs and in 93% of the CR TKAs. Only 2 subjects in each group experienced greater than 1.0 mm of condylar lift-off. Subjects in both TKA groups demonstrated excellent WB ranges of motion and kinematic patterns similar to the normal knee, but less in magnitude.
本研究的目的是确定接受固定后稳定型(PS)或保留交叉韧带型(CR)高屈曲度全膝关节置换术(TKA)的受试者的体内运动学情况。使用荧光透视法对30名受试者(15名PS型,15名CR型)从完全伸展到最大屈曲的三维运动学进行了测定。平均而言,PS型受试者表现出112度的负重(WB)屈曲、6.4毫米的股骨后滚和2.9度的轴向旋转。CR型受试者平均有117度的WB屈曲、4.9毫米的股骨后滚和4.8度的轴向旋转。所有PS型全膝关节置换术以及93%的CR型全膝关节置换术均出现外侧髁的股骨后滚。每组仅2名受试者髁部抬升超过1.0毫米。两个全膝关节置换术组的受试者均表现出出色的负重活动范围,且运动学模式与正常膝关节相似,但幅度较小。