Ishii Yoshinori, Noguchi Hideo, Sato Junko, Yamamoto Takeshi, Takayama Satoshi, Toyabe Shin-Ichi
Ishii Orthopaedic and Rehabilitation Clinic, 1089 Shimo-Oshi, Gyoda, Saitama, 361-0037, Japan.
Division of Information Science and Biostatistics, Niigata University Graduate School of Medical and Dental Sciences, 1 Asahimachi Dori Niigata, Niigata, 951-8520, Japan.
Eur J Orthop Surg Traumatol. 2016 Feb;26(2):205-8. doi: 10.1007/s00590-015-1736-9. Epub 2015 Dec 30.
Sacrifice of the anterior cruciate ligament (ACL) is currently common practice during total knee arthroplasty (TKA). However, patients who receive an ACL-retaining TKA maintain more normal knee kinematic patterns than those without an ACL. Additionally, satisfactory survival and function more than 20 years after bicruciate-retaining TKA has recently been reported. The purpose of this study was to compare the percentage of knees with a visually intact ACL prior to TKA surgery with previously reported values.
A total of 247 knees (216 consecutive patients) that underwent TKA were retrospectively evaluated. The preoperative diagnosis for all patients was primary OA. The macroscopic appearance of the ACL at the time of surgery was retrospectively assessed using routinely recorded digital photographs and classified as normal, moderately damaged (fissured), or completely ruptured. Both normal and moderately damaged ACLs were defined as intact.
Ninety-four percent (233/247) of the knees had an intact ACL (normal or moderately damaged). This value is higher than that found in previous reports.
Our results show more candidates for bicruciate ligament-retaining TKA surgery than reported previously. This suggests that improved techniques for bicruciate-retaining TKA would be clinically useful and could benefit a large number of patients.
目前，在全膝关节置换术（TKA）中牺牲前交叉韧带（ACL）是常见的做法。然而，接受保留ACL的TKA的患者比未保留ACL的患者保持更正常的膝关节运动模式。此外，最近有报道称，保留双交叉韧带的TKA术后20多年的生存率和功能令人满意。本研究的目的是将TKA手术前肉眼可见的ACL完整的膝关节百分比与先前报道的值进行比较。
对总共247例接受TKA的膝关节（216例连续患者）进行回顾性评估。所有患者的术前诊断均为原发性骨关节炎（OA）。利用常规记录的数码照片对手术时ACL的宏观外观进行回顾性评估，并分类为正常、中度损伤（有裂缝）或完全断裂。正常和中度损伤的ACL均定义为完整。
94%（233/247）的膝关节ACL完整（正常或中度损伤）。该值高于先前报道的值。
我们的结果显示，与先前报道相比，保留双交叉韧带的TKA手术的候选患者更多。这表明，改进的保留双交叉韧带的TKA技术在临床上将是有用的，并且可以使大量患者受益。
