Oka Shinya, Matsumoto Tomoyuki, Muratsu Hirotsugu, Kubo Seiji, Matsushita Takehiko, Ishida Kazunari, Kuroda Ryosuke, Kurosaka Masahiro
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1812-8. doi: 10.1007/s00167-013-2535-7. Epub 2013 May 21.
This study aims to make clear the influence of the tibial slope on intra-operative soft tissue balance measurements using a tensor in cruciate-retaining and posterior-stabilized total knee arthroplasty (TKA).
Forty patients with osteoarthritis of the knee received TKAs (20 cruciate-retaining TKAs and 20 posterior-stabilized TKA). Soft tissue balance was measured using an offset type tensor at 0, 10, 45, 90, 135 degrees of knee flexion. The tibial slopes were measured by post-operative lateral radiograph. The correlation between the tibial slope and values of soft tissue balance were assessed.
Joint component gap at 90° (R = 0.537, p < 0.01) and 135° (R = 0.463, p < 0.05) of flexion and joint component gap change value of 90-0° (R = 0.433, p < 0.05) showed positive correlations with tibial slope in posterior-stabilized TKA. There was no relationship between the tibial slope and the value of soft tissue balances in cruciate-retaining TKA.
In the present study, we confirmed that increasing the tibial slope resulted in a larger flexion gap compared to extension gap in posterior-stabilized TKA. Surgeons should be aware that increasing the tibial slope is one factor responsible for widening the flexion-extension gap difference in posterior-stabilized TKA.
本研究旨在明确胫骨坡度对使用张量进行保留交叉韧带和后稳定型全膝关节置换术(TKA)术中软组织平衡测量的影响。
40例膝关节骨关节炎患者接受了全膝关节置换术(20例保留交叉韧带的全膝关节置换术和20例后稳定型全膝关节置换术)。在膝关节屈曲0°、10°、45°、90°、135°时使用偏置型张量测量软组织平衡。术后通过侧位X线片测量胫骨坡度。评估胫骨坡度与软组织平衡值之间的相关性。
在后稳定型全膝关节置换术中,90°(R = 0.537,p < 0.01)和135°(R = 0.463,p < 0.05)屈曲时的关节组件间隙以及90 - 0°的关节组件间隙变化值(R = 0.433,p < 0.05)与胫骨坡度呈正相关。在保留交叉韧带的全膝关节置换术中,胫骨坡度与软组织平衡值之间没有关系。
在本研究中,我们证实增加胫骨坡度会导致后稳定型全膝关节置换术中屈曲间隙比伸直间隙更大。外科医生应意识到增加胫骨坡度是导致后稳定型全膝关节置换术中屈伸间隙差异增大的一个因素。