Malviya Ajay, Lingard E A, Weir D J, Deehan D J
Department of Orthopaedic Surgery, Freeman Hospital, Newcastle upon Tyne, UK.
Knee Surg Sports Traumatol Arthrosc. 2009 May;17(5):491-8. doi: 10.1007/s00167-008-0712-x. Epub 2009 Jan 13.
We have attempted to quantify the influence of clinical, radiological and prosthetic design factors upon flexion following knee replacement. Our study examined the outcome following 101 knee replacements performed in two prospective randomized trials using similar cruciate retaining implants. Multivariate analyses, after adjusting for age, sex, diagnosis and the type of prosthesis revealed that the only significant correlates for range of movement at 12 months were the difference in posterior condylar offset ratio (p < 0.001), tibial slope (p < 0.001) and preoperative range of movement (p = 0.025). We found a moderate correlation between 12-month range of movement and posterior tibial slope (R = 0.58) and the difference of post femoral condylar offset (i.e, post-operative minus preoperative posterior condylar offset, R = 0.65). Posterior condylar offset had the greatest impact upon final range of movement highlighting this as an important consideration for the operating surgeon at pre-operative templating when choosing both the design and size of the femoral component.
我们试图量化临床、放射学和假体设计因素对膝关节置换术后屈曲的影响。我们的研究检查了在两项前瞻性随机试验中使用相似的保留交叉韧带假体进行的101例膝关节置换术的结果。在对年龄、性别、诊断和假体类型进行调整后的多变量分析显示，12个月时活动范围的唯一显著相关因素是后髁偏移率差异（p < 0.001）、胫骨坡度（p < 0.001）和术前活动范围（p = 0.025）。我们发现12个月活动范围与胫骨后坡度（R = 0.58）以及股骨后髁偏移差异（即术后减去术前的后髁偏移，R = 0.65）之间存在中度相关性。后髁偏移对最终活动范围影响最大，这突出表明在术前模板设计时，对于手术医生选择股骨部件的设计和尺寸而言，这是一个重要的考虑因素。
