Department of Orthopaedic Surgery, Spital Netz Bern Ziegler, Morillonstrasse 75-91, 3001 Berne, Switzerland.
Knee Surg Sports Traumatol Arthrosc. 2011 Jul;19(7):1113-20. doi: 10.1007/s00167-010-1364-1. Epub 2011 Jan 14.
A functional posterior cruciate ligament (PCL) is important for the knee stability after PCL-retaining total knee arthroplasty (TKA). The objectives of this study were to determine the anteroposterior (AP) displacement of the knee after a mobile- or fixed-bearing PCL-retaining TKA operated with a ligament-balancing technique and the correlation of AP stability with the clinical outcome.
The AP displacement of 160 TKAs in 143 patients was measured pre- and intra-operatively, and the results were compared to the AP displacement measured 4 years post-surgery.
The change in AP displacement from intra-operative measurement to follow-up at the 25° measuring point was -1.2 mm; at 90°, it was -0.2 mm. Mobile bearings showed significantly greater AP displacement than fixed bearings. Older patients, male patients and patients receiving a fixed prosthesis had lower post-operative laxity compared with the overall population.
The small change in AP displacement indicates that the PCL remains functional over time. In our study, we could not find any correlation between knee AP stability and clinical outcome, including passive flexion, Knee Society Score or Visual Analogue Scale of pain and satisfaction.
保留后交叉韧带(PCL)的功能性对于后交叉韧带保留型全膝关节置换术(TKA)后膝关节的稳定性非常重要。本研究的目的是确定采用韧带平衡技术进行的活动平台或固定平台保留后交叉韧带 TKA 术后膝关节的前后(AP)位移,并探讨 AP 稳定性与临床结果的相关性。
测量了 143 名患者的 160 例 TKA 的术前和术中 AP 位移,并将结果与术后 4 年的 AP 位移进行比较。
从术中测量到随访 25°测量点的 AP 位移变化为-1.2mm;在 90°时为-0.2mm。活动平台的 AP 位移明显大于固定平台。与总体人群相比,老年患者、男性患者和接受固定假体的患者术后松弛度较低。
AP 位移的微小变化表明 PCL 随着时间的推移仍保持功能。在我们的研究中,我们未发现膝关节 AP 稳定性与临床结果(包括被动屈曲、膝关节协会评分或疼痛和满意度的视觉模拟量表)之间存在任何相关性。