Yang Jae-Hyuk, Seo Jai-Gon, Moon Young-Wan, Kim Mu-Hyun
Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
Orthopedics. 2009 Oct;32(10 Suppl):35-9. doi: 10.3928/01477447-20090915-57.
The purpose of this study was to analyze the clinical results of patients who underwent navigation-assisted cruciate ligament retention-type mobile-bearing total knee arthroplasty (TKA) according to joint line changes. From September 2004 to January 2006, cruciate ligament retention-type mobile-bearing TKAs were performed using a navigation system (OrthoPilot; B. Braun Aesculap, Tuttlingen, Germany) on 50 knees in 45 patients (2 men, 43 women). The mean follow-up period was 46 (range, 39-55 months), and patient mean age was 65 years. There was 1 case of rheumatic arthritis; all others were of degenerative arthritis. Proximal tibia resection was performed at the sclerotic level of the medial tibial plateau. The distance from the lowest point of lateral tibial plateau (registered point) to the proximal resection plane was measured. Clinical outcomes (range of motion, Knee Society Score) were compared for joint line elevations of > or =3 mm (20 cases) and <3 mm (30 cases). Mean joint line elevation was 1.93 mm (range, -1-5 mm). Joint line change was not found to be associated with difference of clinical results (P>.05). The findings of this study suggest that joint line changes in the range of -1 to 5 mm after cruciate ligament retention-type mobile-bearing TKA do not affect clinical outcome.
本研究的目的是根据关节线变化分析接受导航辅助下保留交叉韧带的活动平台全膝关节置换术(TKA)患者的临床结果。2004年9月至2006年1月,对45例患者(2例男性,43例女性)的50个膝关节使用导航系统(OrthoPilot;德国图特林根市贝朗蛇牌)进行了保留交叉韧带的活动平台TKA手术。平均随访期为46个月(范围39 - 55个月),患者平均年龄为65岁。其中1例为风湿性关节炎;其他均为退行性关节炎。在胫骨内侧平台硬化水平进行近端胫骨截骨。测量外侧胫骨平台最低点(注册点)到近端截骨平面的距离。比较关节线抬高≥3 mm(20例)和<3 mm(30例)患者的临床结果(活动范围、膝关节协会评分)。平均关节线抬高为1.93 mm(范围 - 1 - 5 mm)。未发现关节线变化与临床结果差异相关(P>0.05)。本研究结果表明,保留交叉韧带的活动平台TKA术后关节线在 - 1至5 mm范围内的变化不影响临床结果。