Okamoto Shigetoshi, Mizu-uchi Hideki, Okazaki Ken, Hamai Satoshi, Nakahara Hiroyuki, Iwamoto Yukihide
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Arthroplasty. 2015 Aug;30(8):1439-43. doi: 10.1016/j.arth.2015.02.042. Epub 2015 Mar 7.
We used a musculoskeletal model validated with in vivo data to evaluate the effect of tibial posterior slope on knee kinematics, quadriceps force, and patellofemoral contact force after posterior-stabilized total knee arthroplasty. The maximum quadriceps force and patellofemoral contact force decreased with increasing posterior slope. Anterior sliding of the tibial component and anterior impingement of the anterior aspect of the tibial post were observed with tibial posterior slopes of at least 5° and 10°, respectively. Increased tibial posterior slope contributes to improved exercise efficiency during knee extension, however excessive tibial posterior slope should be avoided to prevent knee instability. Based on our computer simulation we recommend tibial posterior slopes of less than 5° in posterior-stabilized total knee arthroplasty.
我们使用一个经体内数据验证的肌肉骨骼模型，来评估后稳定型全膝关节置换术后胫骨后倾角度对膝关节运动学、股四头肌力量和髌股关节接触力的影响。随着后倾角度增加，股四头肌最大力量和髌股关节接触力降低。当胫骨后倾角度分别至少为5°和10°时，观察到胫骨部件向前滑动以及胫骨柱前部向前撞击。增加胫骨后倾角度有助于提高膝关节伸展时的运动效率，然而应避免胫骨后倾角度过大以防止膝关节不稳定。基于我们的计算机模拟，我们建议在后稳定型全膝关节置换术中，胫骨后倾角度小于5°。
