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后交叉韧带保留型内侧旋转铰链全膝关节置换术中的股骨后移

Posterior femoral translation in medial pivot total knee arthroplasty of posterior cruciate ligament retaining type.

作者信息

Cho Su Hyun, Cho Hyung Lae, Lee Soo Ho, Jin Hong Ki

机构信息

Department of Orthopaedic Surgery, Good Samsun Hospital, Busan 617-718, Republic of Korea.

Department of Orthopaedic Surgery, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.

出版信息

J Orthop. 2013 May 18;10(2):74-8. doi: 10.1016/j.jor.2013.04.004. eCollection 2013.

Abstract

PURPOSE

To report clinical results and demonstrate posterior femoral translation (PFT) in medial pivot total knee arthroplasty (TKA) of posterior cruciate ligament (PCL) retaining type.

MATERIALS AND METHODS

A prospective study was performed upon thirty consecutive subjects who were operated on with medial pivot TKA of PCL retaining type between March 2009 and March 2010 and had been followed up for at least 2 years. Clinically, the knee society knee score and function score were used. In full extension and active flexion lateral radiograph, anteroposterior (AP) condylar position and magnitude of PFT was determined.

RESULTS

At last follow-up, the mean knee society knee score and function score improved significantly compared to preoperative scores. The AP condylar positions were consistently posterior to midline throughout the entire range of flexion. The PFTs averaged 0.31 (±0.12) of half length of tibial base plate and were greater in higher flexion cases (r = 0.56, p = 0.0012). There were no cases having either component migration or radiolucent line wider than 2 mm except for one case showing instability related to trauma.

CONCLUSIONS

In medial pivot TKA of PCL retaining type, clinical outcomes were satisfactory and posterior femoral translations were consistently observed during progressive flexions of knees at two- to three-year follow-up.

摘要

目的

报告保留后交叉韧带(PCL)的内侧旋转铰链型全膝关节置换术(TKA)的临床结果,并展示股骨后侧移位(PFT)情况。

材料与方法

对2009年3月至2010年3月间连续30例行保留PCL的内侧旋转铰链型TKA手术且随访至少2年的患者进行前瞻性研究。临床采用膝关节协会膝关节评分和功能评分。在完全伸直和主动屈曲位的外侧X线片上,确定髁间前后位(AP)位置及PFT的大小。

结果

末次随访时,膝关节协会膝关节评分和功能评分较术前显著改善。在整个屈曲范围内,髁间AP位置始终位于中线后方。PFT平均为胫骨基板半长的0.31(±0.12),在屈曲角度较大的病例中更大(r = 0.56,p = 0.0012)。除1例因创伤导致不稳定外,无假体松动或透亮线宽度超过2mm的病例。

结论

在保留PCL的内侧旋转铰链型TKA中,临床效果满意,在2至3年随访期间,膝关节逐渐屈曲时始终观察到股骨后侧移位。

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