Takayama Koji, Matsumoto Tomoyuki, Muratsu Hirotsugu, Uefuji Atsuo, Nakano Naoki, Nagai Kanto, Matsuzaki Tokio, Oka Shinya, Ishida Kazunari, Matsushita Takehiko, Kuroda Ryosuke, Kurosaka Masahiro
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Clin Biomech (Bristol). 2015 Jan;30(1):95-9. doi: 10.1016/j.clinbiomech.2014.10.008. Epub 2014 Oct 31.
The success of unicompartmental knee arthroplasty relies on a lot of factors such as correct osteotomy and proper soft-tissue tensioning. A selection of insert thickness depends solely on the surgeon's subjective feeling. Recently, a tensor that is designed to assess soft tissue balance during unicompartmental knee arthroplasty has been developed. The purpose of this study was to compare the component gap throughout the range of motion among different distraction forces and examine the correlation between the component gap and the insert thickness.
30 cases of 29 patients were included. All the patients received a conventional medial Zimmer Unicompartmental High Flex Knee System. Using a tensor under 10, 20, 30, and 40 lb distraction forces, after femoral component placement, the component gaps were assessed throughout the range of motion. The correlations between the component gap and the insert thickness selected were examined.
The component gap showed the same kinematic pattern among the different distraction forces and the value increased in proportion to the increase of the distraction force in unicompartmental knee arthroplasty. The insert thickness in unicompartmental knee arthroplasty was found to have a strong positive correlation with the component gap from 10 to 45° of knee flexion with a distraction force of more than 20 lb
With the use of the tensor, surgeons can quantify the component gap and objectify their insert thickness decision compared with the use of tension gauge.
单髁膝关节置换术的成功依赖于许多因素，如正确的截骨和适当的软组织张力调节。插入物厚度的选择完全取决于外科医生的主观感觉。最近，一种旨在评估单髁膝关节置换术中软组织平衡的张力计已被开发出来。本研究的目的是比较不同牵张力下整个运动范围内的部件间隙，并检查部件间隙与插入物厚度之间的相关性。
纳入29例患者的30个病例。所有患者均接受传统的内侧齐默单髁高屈曲膝关节系统。在股骨部件放置后，使用张力计在10、20、30和40磅牵张力下，评估整个运动范围内的部件间隙。检查部件间隙与所选插入物厚度之间的相关性。
在不同牵张力下单髁膝关节置换术中，部件间隙呈现相同的运动学模式，且该值随牵张力的增加而呈比例增加。发现在牵张力超过20磅时，单髁膝关节置换术中的插入物厚度与膝关节从10°至45°屈曲时的部件间隙呈强正相关。
与使用张力计相比，使用张力计外科医生可以量化部件间隙并使他们选择插入物厚度的决定更加客观。
