Servien E, Saffarini M, Lustig S, Chomel S, Neyret Ph
Department of Orthopaedic Surgery, Centre Albert-Trillat, Hopital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
Knee Surg Sports Traumatol Arthrosc. 2008 Dec;16(12):1141-5. doi: 10.1007/s00167-008-0620-0. Epub 2008 Sep 9.
The purpose of this study was to analyze the in vivo dimensions of each tibial plateau for planning of unicompartmental knee arthroplasty (UKA), and to compare the morphometric data to the dimensions of nine current designs of UKA tibial components. Thirty-seven knees (31 females and 6 males) operated on with UKA were studied. All patients were examined postoperatively using computed tomography (CT). There were 18 lateral and 19 medial UKAs. On the CT scan, each operated tibial plateau was measured in the transverse plane at the resection level, just below the full polyethylene tibial component. We measured the length of the anteroposterior (AP) cut as well as the maximal mediolateral dimension of the resected plateau (perpendicular to the AP cut). We compared the measurements with nine current UKA systems: Accuris (Smith and Nephew), Advance (Wright Medical), HLS Uni Evolution (Tornier), Miller-Galante and "ZUK" (Zimmer), Oxford and Oxford alpha (Biomet), Preservation (DePuy) and Unix (Stryker). There was good correlation between patient height and mediolateral dimension (r=0.6), and between patient height and area of total tibial plateau (r=0.7). The anteroposterior dimension was greater for the medial plateau (mean 50.8 mm, SD 3.3) than for the lateral plateau (mean 47.2 mm, SD 3.3). This difference was statistically significant (P=0.0016). Some UKA implants are designed with an asymmetric femoral component, but none have an asymmetric tibial component. The present study suggests, however, that the shape of the medial tibial plateau differs from that of the lateral plateau. This difference can lead to mediolateral overhang for medial UKA, if the surgeon aims for optimal anteroposterior coverage.
本研究的目的是分析每个胫骨平台的体内尺寸，以用于单髁膝关节置换术（UKA）的规划，并将形态学数据与九种当前UKA胫骨组件设计的尺寸进行比较。对37例行UKA手术的膝关节（31例女性和6例男性）进行了研究。所有患者术后均使用计算机断层扫描（CT）进行检查。其中有18例外侧UKA和19例内侧UKA。在CT扫描上，在切除水平的横断面上测量每个手术胫骨平台，恰好在全聚乙烯胫骨组件下方。我们测量了前后（AP）截骨的长度以及切除平台的最大内外侧尺寸（垂直于AP截骨）。我们将测量结果与九种当前的UKA系统进行了比较：Accuris（史赛克）、Advance（捷迈医疗）、HLS Uni Evolution（索林集团）、Miller-Galante和“ZUK”（捷迈）、牛津和牛津α（百美）、Preservation（迪普伊）和Unix（史赛克）。患者身高与内外侧尺寸之间存在良好的相关性（r = 0.6），患者身高与胫骨平台总面积之间也存在良好的相关性（r = 0.7）。内侧平台的前后尺寸（平均50.8 mm，标准差3.3）大于外侧平台（平均47.2 mm，标准差3.3）。这种差异具有统计学意义（P = 0.0016）。一些UKA植入物设计有不对称的股骨组件，但没有一个有不对称胫骨组件。然而，本研究表明，内侧胫骨平台的形状与外侧平台不同。如果外科医生旨在实现最佳的前后覆盖，这种差异可能导致内侧UKA出现内外侧悬垂。
