AZ St-Lucas, St-Lucaslaan, 8310 Brugge, Belgium.
Clin Orthop Relat Res. 2010 Mar;468(3):807-14. doi: 10.1007/s11999-009-1072-7. Epub 2009 Sep 4.
Patterns of motion in the native knee show substantial variability. Guided motion prosthetic designs offer stability but may limit natural variability. To assess these limits, we therefore determined the in vivo kinematic patterns for patients having a cruciate-substituting TKA of one design and determined the intersurgeon variability associated with a guided-motion prosthetic design. Three-dimensional femorotibial contact positions were evaluated for 86 TKAs in 80 subjects from three different surgeons using fluoroscopy during a weightbearing deep knee bend. The average posterior femoral rollback of the medial and lateral condyles for all TKAs from full extension to maximum flexion was -14.0 mm and -23.0 mm, respectively. The average axial tibiofemoral rotation from full extension to maximum flexion for all TKAs was 10.8 degrees. The average weightbearing range of motion (ROM) was 109 degrees (range, 60 degrees-150 degrees; standard deviation, 18.7 degrees). Overall, the TKA showed axial rotation patterns similar to those of the normal knee, although less in magnitude. Surgeon-to-surgeon comparison revealed dissimilarities, showing the surgical technique and soft tissue handling influence kinematics in a guided-motion prosthetic design.
Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
自然膝关节的运动模式存在很大的可变性。导向运动假体设计提供了稳定性，但可能限制了自然变化。因此，为了评估这些限制，我们确定了一种设计的交叉韧带替代 TKA 患者的体内运动模式，并确定了与导向运动假体设计相关的外科医生间的可变性。使用透视法，在负重深膝弯曲期间，对来自三个不同外科医生的 80 名受试者的 86 个 TKA 评估了三维股骨胫骨接触位置。所有 TKA 从完全伸展到最大屈曲时，内侧和外侧髁的平均股骨后滚分别为-14.0 毫米和-23.0 毫米。所有 TKA 从完全伸展到最大屈曲时的平均轴向胫骨股骨旋转为 10.8 度。平均负重运动范围（ROM）为 109 度（范围为 60 度至 150 度；标准差为 18.7 度）。总体而言，TKA 显示出与正常膝关节相似的轴向旋转模式，尽管幅度较小。外科医生间的比较显示出差异，表明手术技术和软组织处理会影响导向运动假体设计中的运动学。
三级，治疗研究。有关证据水平的完整描述，请参见作者指南。
