Seon J K, Park S J, Yoon T R, Lee K B, Moon E S, Song E K
Department of Orthopaedic Surgery, Center for Joint Disease, Chonnam National University, Hwasun Hospital, 160 ilsimri, Hwasun, South Korea.
J Bone Joint Surg Br. 2010 Aug;92(8):1090-5. doi: 10.1302/0301-620X.92B8.23980.
The amount of anteroposterior laxity required for a good range of movement and knee function in a cruciate-retaining total knee replacement (TKR) continues to be debated. We undertook a retrospective study to evaluate the effects of anteroposterior laxity on the range of movement and knee function in 55 patients following the e-motion cruciate-retaining TKR with a minimum follow-up of two years. The knees were divided into stable (anteroposterior translation, < or = 10 mm, 38 patients) and unstable (anteroposterior translation, > 10 mm, 17) groups based on the anteroposterior laxity, measured using stress radiographs. We compared the Hospital for Special Surgery (HSS) scores, the Western Ontario MacMasters University Osteoarthritis (WOMAC) index, weight-bearing flexion, non-weight-bearing flexion and the reduction of flexion under weight-bearing versus non-weight-bearing conditions, which we referred to as delta flexion, between the two groups at the final follow-up. There were no differences between the stable and unstable groups with regard to the mean HHS and WOMAC total scores, as well as weight-bearing and non-weight-bearing flexion (p = 0.277, p = 0.082, p = 0.095 and p = 0.646, respectively). However, the stable group had a better WOMAC function score and less delta flexion than the unstable group (p = 0.011 and p = 0.005, respectively). Our results suggest that stable knees with laxity < or = 10 mm have a good functional outcome and less reduction of flexion under weight-bearing conditions than unstable knees with laxity > 10 mm following an e-motion cruciate-retaining TKR.
在保留交叉韧带的全膝关节置换术（TKR）中，实现良好的活动范围和膝关节功能所需的前后向松弛量仍存在争议。我们进行了一项回顾性研究，以评估55例接受e-motion保留交叉韧带TKR且至少随访两年的患者中，前后向松弛对活动范围和膝关节功能的影响。根据使用应力X线片测量的前后向松弛情况，将膝关节分为稳定组（前后向平移≤10 mm，38例患者）和不稳定组（前后向平移>10 mm，17例）。我们比较了两组在最终随访时的特种外科医院（HSS）评分、西安大略麦克马斯特大学骨关节炎（WOMAC）指数、负重屈曲、非负重屈曲以及负重与非负重条件下屈曲减少量（我们称之为屈曲差值）。稳定组和不稳定组在平均HHS和WOMAC总分以及负重和非负重屈曲方面无差异（分别为p = 0.277、p = 0.082、p = 0.095和p = 0.646）。然而，稳定组的WOMAC功能评分更好，屈曲差值比不稳定组更小（分别为p = 0.011和p = 0.005）。我们的结果表明，在e-motion保留交叉韧带TKR后，前后向松弛≤10 mm的稳定膝关节比前后向松弛>10 mm的不稳定膝关节具有更好的功能结果，且在负重条件下屈曲减少量更小。
