Oh Chang-Seon, Song Eun Kyoo, Seon Jong Keun, Ahn Yeong Seub
Center for Joint Disease, Chonnam National University Hwasun Hospital, Jeonnam, South Korea.
Arch Orthop Trauma Surg. 2015 Mar;135(3):401-6. doi: 10.1007/s00402-015-2159-0. Epub 2015 Jan 30.
We investigated the relations between flexion balances and functional outcomes after total knee arthroplasty (TKA).
Sixty-one knees that underwent a TKA were included in this study. Clinical assessments were performed and flexion balances of the knee were assessed on varus and valgus stress radiographs at 90° of knee flexion. Total laxity was defined as the sum of medial and lateral laxities. Knees were divided into balanced (≤3°, n = 51) and unbalanced (>3°, n = 10) groups based on the only difference of mediolateral laxity regardless of total laxity. And the balanced group was divided into Grade I (<6°), Grade II (≥6° but ≤10°) or Grade III (>10°) groups based on the amount of total laxity.
Although no statistically significant differences were observed between the balanced and unbalanced groups in terms of range of motion (ROM) and KS pain scores, the balanced group achieved better results in terms of KS function and WOMAC scores than the unbalanced group. Total laxity was significantly less in the balanced group. In addition, Grade II knees in the balanced group had significantly better KS pain and function scores, and WOMAC scores than Grade Ior Grade III knees.
These results suggest that total knees with good balanced flexion stability can provide good functional outcomes after TKA.
我们研究了全膝关节置换术（TKA）后屈曲平衡与功能结果之间的关系。
本研究纳入了61例行TKA的膝关节。进行了临床评估，并在膝关节屈曲90°时的内翻和外翻应力X线片上评估膝关节的屈曲平衡。总松弛度定义为内侧和外侧松弛度之和。根据内外侧松弛度的唯一差异，无论总松弛度如何，将膝关节分为平衡组（≤3°，n = 51）和不平衡组（>3°，n = 10）。平衡组根据总松弛度的大小分为I级（<6°）、II级（≥6°但≤10°）或III级（>10°）组。
虽然平衡组和不平衡组在活动范围（ROM）和KS疼痛评分方面没有观察到统计学上的显著差异，但平衡组在KS功能和WOMAC评分方面比不平衡组取得了更好的结果。平衡组的总松弛度明显更小。此外，平衡组中的II级膝关节在KS疼痛和功能评分以及WOMAC评分方面比I级或III级膝关节明显更好。
这些结果表明，具有良好平衡屈曲稳定性的全膝关节在TKA后可以提供良好的功能结果。
