Patil Shantanu, Bunn Adam, Bugbee William D, Colwell Clifford W, D'Lima Darryl D
Knee. 2015 Dec;22(6):624-9. doi: 10.1016/j.knee.2015.08.002.
Nearly 14% to 39% TKA patients report dissatisfaction causing incomplete return of function. We proposed that the kinematics of knees implanted with patient-specific prostheses using patient-specific cutting guides would be closer to normal.
Eighteen matched cadaver lower limbs were randomly assigned to two groups: group A was implanted with patient-specific implants using patient-specific cutting guides; group B, the contralateral knee, was implanted with a standard design using intramedullary alignment cutting guides. Knee kinematics were measured on a dynamic closed-kinetic-chain Oxford knee rig, simulating a deep knee bend and in a passive rig testing varus-valgus laxity.
The difference from normal kinematics was lower for group A compared to group B for active femoral rollback, active tibiofemoral adduction, and for passive varus-valgus laxity.
Our results support the hypothesis that knees with patient-specific implants generate kinematics more closely resembling normal knee kinematics than standard knee designs.
Restoring normal kinematics may improve function and patient satisfaction after total knee arthroplasty.
近14%至39%的全膝关节置换术（TKA）患者报告存在不满意情况，导致功能未能完全恢复。我们提出，使用患者特异性截骨导向器植入患者特异性假体的膝关节运动学更接近正常。
将18对匹配的尸体下肢随机分为两组：A组使用患者特异性截骨导向器植入患者特异性假体；B组为对侧膝关节，使用髓内对线截骨导向器植入标准设计假体。在动态闭链牛津膝关节试验台上测量膝关节运动学，模拟深度屈膝，并在被动试验台上测试内翻-外翻松弛度。
在主动股骨后滚、主动胫股内收以及被动内翻-外翻松弛度方面，A组与正常运动学的差异低于B组。
我们的结果支持以下假设，即与标准膝关节设计相比，植入患者特异性假体的膝关节产生的运动学更接近正常膝关节运动学。
恢复正常运动学可能会改善全膝关节置换术后的功能和患者满意度。
