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全膝关节置换术中的膝关节运动。Tricon-M膝关节假体运动学的X线立体摄影测量分析。

Knee motion in total knee arthroplasty. A roentgen stereophotogrammetric analysis of the kinematics of the Tricon-M knee prosthesis.

作者信息

Nilsson K G, Kärrholm J, Ekelund L

机构信息

Department of Orthopedics, University Hospital, Umeå, Sweden.

出版信息

Clin Orthop Relat Res. 1990 Jul(256):147-61.

PMID:2364604
Abstract

The three-dimensional kinematics of the Tricon-M knee prosthesis during active knee flexion and extension were recorded in 11 patients with arthrosis or rheumatoid arthritis using roentgen stereophotogrammetric analysis. Twenty-three normal knees constituted the control group. The prosthetic knees displayed the same degrees of freedom regarding rotational and translational movements as the normal knees, although the kinematics were different. A combination of internal rotation, abduction, and lateral translation of the tibia was recorded during flexion, and the reversed movements were recorded during extension. During the first 25 degrees of flexion, these movements were small, reflecting the high congruency between the articular surfaces, while beyond 25 degrees they increased. The normal knees displayed a combination of internal rotation, adduction, and medial translation of the tibia during flexion and the reversed movements during extension. The prosthetic knees also exhibited an increased posterior displacement during increasing flexion when compared with the normal knees. There was a correlation between the positioning of the femoral component in the sagittal plane and the recorded anterior/posterior translations. In conclusion, the kinematics of the Tricon-M knee prosthesis significantly differ from the normal knee, probably because of the design of the prosthesis and the absence of the cruciate ligaments.

摘要

采用X线立体摄影测量分析技术,记录了11例患有关节炎或类风湿性关节炎患者在膝关节主动屈伸过程中Tricon - M膝关节假体的三维运动学情况。23个正常膝关节作为对照组。尽管假体膝关节的运动学情况不同,但其在旋转和平移运动方面具有与正常膝关节相同的自由度。屈膝过程中记录到胫骨内旋、外展和侧向平移的组合运动,伸膝过程中记录到相反的运动。在屈膝的最初25度内,这些运动较小,反映了关节面之间的高度一致性,而超过25度时运动增加。正常膝关节在屈膝时表现为胫骨内旋、内收和向内侧平移的组合运动,伸膝时为相反运动。与正常膝关节相比,假体膝关节在屈膝增加时也表现出后移增加。股骨部件在矢状面的位置与记录的前后平移之间存在相关性。总之,Tricon - M膝关节假体的运动学情况与正常膝关节显著不同,这可能是由于假体设计和交叉韧带缺失所致。

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