Minoda Yukihide, Ikebuchi Mitsuhiko, Mizokawa Shigekazu, Ohta Yoichi, Nakamura Hiroaki
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi Abeno-ku, Osaka, 545-8585, Japan.
Arch Orthop Trauma Surg. 2016 Nov;136(11):1601-1606. doi: 10.1007/s00402-016-2567-9. Epub 2016 Sep 13.
Proper anteroposterior (AP) joint displacement is an important indicator of good clinical outcome following total knee arthroplasty (TKA). We hypothesized that a newly introduced mobile-bearing posterior stabilized (PS) prosthesis reduces the AP joint displacement. The aim of this study is to compare the AP joint displacement between a newly introduced mobile-bearing PS TKA in one knee and a conventional fixed-bearing PS TKA in other knee.
82 knees in 41 patients who had bilateral TKAs were investigated. All the patients received a conventional fixed-bearing PS prosthesis in one knee and a highly congruent mobile-bearing PS prosthesis in the other knee. AP joint displacement was measured using the KT-2000 arthrometer, at 30° and 75° in flexion, at average of 3.3 years after the operation.
AP joint displacements at 30° in flexion were 6 ± 3 mm in the knees with the mobile-bearing PS prosthesis and 9 ± 4 mm in the knee with fixed-bearing PS prosthesis (p < 0.001). AP joint displacements at 75° in flexion were 4 ± 2 mm in the knees with the mobile-bearing PS prosthesis and 6 ± 3 mm in the knee with fixed-bearing PS prosthesis (p < 0.001).
This study suggested that the design of the prosthesis can improve the AP joint stability in mid-flexion range.
合适的前后(AP)关节位移是全膝关节置换术(TKA)后良好临床结果的重要指标。我们假设一种新引入的活动平台后稳定型(PS)假体可减少AP关节位移。本研究的目的是比较一侧膝关节采用新引入的活动平台PS TKA与另一侧膝关节采用传统固定平台PS TKA时的AP关节位移。
对41例行双侧TKA患者的82个膝关节进行研究。所有患者一侧膝关节接受传统固定平台PS假体,另一侧膝关节接受高度匹配的活动平台PS假体。术后平均3.3年时,使用KT-2000关节测量仪在屈膝30°和75°时测量AP关节位移。
活动平台PS假体膝关节在屈膝30°时的AP关节位移为6±3mm,固定平台PS假体膝关节为9±4mm(p<0.001)。活动平台PS假体膝关节在屈膝75°时的AP关节位移为4±2mm,固定平台PS假体膝关节为6±3mm(p<0.001)。
本研究表明假体设计可改善屈膝中间范围的AP关节稳定性。