Matsuzaki Tokio, Matsumoto Tomoyuki, Muratsu Hirotsugu, Ishida Kazunari, Takayama Koji, Nagai Kanto, Nakano Naoki, Nishida Kyohei, Kuroda Ryosuke, Kurosaka Masahiro
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Orthopaedic Surgery, Steel Memorial Hirohata Hospital, Himeji, Hyogo, Japan.
Knee Surg Sports Traumatol Arthrosc. 2017 Jan;25(1):272-276. doi: 10.1007/s00167-014-3493-4. Epub 2014 Dec 25.
Given the knee kinematics and soft tissue balance in unicompartmental knee arthroplasty (UKA), it was hypothesised that intraoperative medial compartment stability will result in good functional outcome. The purpose of this study was to test the influence of soft tissue balance on post-operative knee flexion in UKA.
The influence of soft tissue balance on post-operative knee flexion in UKA was first examined retrospectively by using a newly developed tensor device in 30 consecutive patients diagnosed with either isolated medial compartmental osteoarthritis or idiopathic necrosis. The intraoperative component gap of the medial compartment was measured by using the tensor while applying a 20-lb joint distraction force at 0°, 10°, 30°, 45°, 60°, 90°, 120°, and 135° of knee flexion, with calculation of the joint looseness. Correlations between the soft tissue parameters and post-operative knee flexion angles were analysed 1 year after surgery.
The post-operative knee flexion angle was negatively correlated with the component gap at 45°, 60°, and 90° of flexion (R = -0.41, P < 0.05; R = -0.44, P < 0.05; and R = -0.44, P < 0.05, respectively). Furthermore, the post-operative knee flexion angle was negatively correlated with joint looseness at 45°, 60°, and 90° of flexion (R = -0.40, P < 0.05; R = -0.41, P < 0.05; and R = -0.36, P < 0.05, respectively).
The intraoperative medial compartment stability of knee flexion in midrange resulted in increasing post-operative knee flexion angle in UKA. Medial soft tissue release should be minimised, and assessment of soft tissue balance using a tensor can be performed to predict the post-operative knee flexion angle during surgery for UKA.
III.
鉴于单髁膝关节置换术（UKA）中的膝关节运动学和软组织平衡，我们假设术中内侧间室稳定性将带来良好的功能结果。本研究的目的是测试软组织平衡对UKA术后膝关节屈曲的影响。
首先，使用一种新开发的张量装置，对30例连续诊断为孤立性内侧间室骨关节炎或特发性坏死的患者进行回顾性研究，以检验软组织平衡对UKA术后膝关节屈曲的影响。术中在内侧间室施加20磅的关节牵张力，分别在膝关节屈曲0°、10°、30°、45°、60°、90°、120°和135°时，使用张量测量内侧间室的组件间隙，并计算关节松动度。术后1年分析软组织参数与术后膝关节屈曲角度之间的相关性。
术后膝关节屈曲角度与屈曲45°、60°和90°时的组件间隙呈负相关（分别为R = -0.41，P < 0.05；R = -0.44，P < 0.05；R = -0.44，P < 0.05）。此外，术后膝关节屈曲角度与屈曲45°、60°和90°时的关节松动度呈负相关（分别为R = -0.40，P < 0.05；R = -0.41，P < 0.05；R = -0.36，P < 0.05）。
术中膝关节在中等范围屈曲时内侧间室的稳定性导致UKA术后膝关节屈曲角度增加。应尽量减少内侧软组织松解，并且可以使用张量评估软组织平衡，以在UKA手术期间预测术后膝关节屈曲角度。
III级。
