De Keyser Wouter, Beckers Leo
Imelda Hospital, Bonheiden, Belgium.
Acta Orthop Belg. 2010 Dec;76(6):799-805.
Post-operative joint stability and ligament balance are crucial factors in the longevity of the prosthesis after total knee arthroplasty (TKA). The influence of patellar position on the balance of the knee is controversial. We studied the influence of patellar subluxation on tibiofemoral pressure distribution in vivo, in 32 knees undergoing TKA through a subvastus approach. We used the e-LIBRA Dynamic Knee Balancing System (Synvasive Technology, El Dorado Hills, CA, USA). This is a device that measures the pressures in the medial and lateral compartment independently. After balancing the knee in flexion with the patella in place, we demonstrated a significant rise in pressure in the medial compartment with subluxation of the patella (p < 0.0001). Our findings give a new insight on the role of the patellar position while balancing a total knee arthroplasty. Surgeons should be aware of this effect when choosing their surgical technique for this operative procedure.
术后关节稳定性和韧带平衡是全膝关节置换术（TKA）后假体使用寿命的关键因素。髌骨位置对膝关节平衡的影响存在争议。我们研究了髌骨半脱位对32例经股直肌下入路行TKA的膝关节胫股压力分布的体内影响。我们使用了e-LIBRA动态膝关节平衡系统（Synvasive Technology，美国加利福尼亚州埃尔多拉多山）。这是一种可独立测量内侧和外侧间室压力的设备。在髌骨在位的情况下使膝关节在屈曲位平衡后，我们发现髌骨半脱位时内侧间室压力显著升高（p < 0.0001）。我们的研究结果为全膝关节置换术平衡时髌骨位置的作用提供了新的见解。外科医生在选择该手术的手术技术时应意识到这种影响。
