Nicoll D, Rowley D I
Department of Orthopaedic & Trauma Surgery, Ninewells Hospital & Medical School, Dundee, UK.
J Bone Joint Surg Br. 2010 Sep;92(9):1238-44. doi: 10.1302/0301-620X.92B9.23516.
This study used CT analysis to determine the rotational alignment of 39 painful and 26 painless fixed-bearing total knee replacements (TKRs) from a cohort of 740 NexGen Legacy posterior-stabilised and cruciate-retaining prostheses implanted between May 1996 and August 2003. The mean rotation of the tibial component was 4.3 degrees of internal rotation (25.4 degrees internal to 13.9 degrees external rotation) in the painful group and 2.2 degrees of external rotation (8.5 degrees internal to 18.2 degrees external rotation) in the painfree group (p = 0.024). In the painful group 17 tibial components were internally rotated more than 9 degrees compared with none in the painfree group (p < 0.001). Additionally, six femoral components in the painful group were internally rotated more than 6 degrees compared with none in the painfree group (p = 0.017). External rotational errors were not found to be associated with pain. Overall, 22 (56.4%) of the painful TKRs had internal rotational errors involving the femoral, the tibial or both components. It is estimated that at least 4.6% of all our TKRs have been implanted with significant internal rotational errors.
本研究采用CT分析，以确定1996年5月至2003年8月间植入的740例NexGen Legacy后稳定型和交叉韧带保留型假体队列中39例疼痛的和26例无痛的固定平台全膝关节置换术（TKR）的旋转对线情况。疼痛组胫骨部件的平均旋转角度为内旋4.3度（从内旋25.4度至外旋13.9度），无痛组为外旋2.2度（从内旋8.5度至外旋18.2度）（p = 0.024）。在疼痛组中，17个胫骨部件的内旋角度超过9度，而无痛组中没有（p < 0.001）。此外，疼痛组中有6个股骨部件的内旋角度超过6度，无痛组中没有（p = 0.017）。未发现外旋误差与疼痛有关。总体而言，22例（56.4%）疼痛的TKR存在涉及股骨、胫骨或两者部件的内旋误差。据估计，我们所有的TKR中至少有4.6%植入时存在明显的内旋误差。
