Takayama Koji, Matsumoto Tomoyuki, Muratsu Hirotsugu, Ishida Kazunari, Araki Daisuke, 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.
Knee. 2016 Jun;23(3):517-22. doi: 10.1016/j.knee.2016.01.003. Epub 2016 Jan 29.
The effect of posterior slope on joint gap in unicompartmental knee arthroplasty (UKA) has yet to be quantified. The purpose of this study was to quantify the effect of the tibial slope on the joint component gap and postoperative range of motion in UKA.
Forty consecutive patients were prospectively enrolled. The correlation between the tibial slope changes and the component gap, the component gap difference between flexion angles, the postoperative extension or flexion angles was examined. The correlation of joint looseness with tibial slope changes and postoperative extension angle was also examined.
Increased tibial slope positively correlated with the differences between the component gap at 90° and 10°, 120° and 10°, or 135° and 10° knee flexion angle. Although tibial slope change did not affect postoperative flexion angle, increased tibial slope reduced postoperative extension angle. Moreover, increased tibial slope resulted in decreased joint looseness during 10° of knee flexion and decreased joint looseness during 10° of knee flexion resulted in reduced postoperative extension angle.
Increased tibial slope resulted in tight component gap at knee extension compared with that at knee flexion. Furthermore, tight component gap at extension lead to decreased postoperative extension angle. These results indicate that an individual anatomical tibial slope should be considered when tibial sagittal osteotomy was performed and increasing tibial slope should be avoided to achieve full extension angle after UKA.
II.
在单髁膝关节置换术（UKA）中，后倾角度对关节间隙的影响尚未得到量化。本研究的目的是量化胫骨后倾角度对UKA中关节组件间隙和术后活动范围的影响。
前瞻性纳入40例连续患者。研究胫骨后倾角度变化与组件间隙、不同屈曲角度下组件间隙差异、术后伸直或屈曲角度之间的相关性。同时研究关节松动与胫骨后倾角度变化及术后伸直角度之间的相关性。
胫骨后倾角度增加与膝关节屈曲90°和10°、120°和10°或135°和10°时组件间隙的差异呈正相关。虽然胫骨后倾角度变化不影响术后屈曲角度，但胫骨后倾角度增加会减小术后伸直角度。此外，胫骨后倾角度增加导致膝关节屈曲10°时关节松动度降低，而膝关节屈曲10°时关节松动度降低导致术后伸直角度减小。
与膝关节屈曲时相比，胫骨后倾角度增加导致膝关节伸直时组件间隙变窄。此外，伸直时组件间隙变窄导致术后伸直角度减小。这些结果表明，在进行胫骨矢状截骨时应考虑个体解剖学胫骨后倾角度，并且应避免增加胫骨后倾角度以在UKA后实现完全伸直角度。
II级。
