Weinberg Douglas S, Gebhart Jeremy J, Wera Glenn D
Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.
Department of Orthopaedic Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
J Arthroplasty. 2017 May;32(5):1659-1664.e1. doi: 10.1016/j.arth.2016.12.022. Epub 2016 Dec 22.
Posterior condylar offset (PCO) and posterior tibial slope (PTS) have critical consequences in total knee arthroplasty, especially with regards to sagittal plane balancing. However, there has only been limited investigation into the functional consequences of each, and there have only been anecdotal observations regarding any associations between PCO and PTS.
In a large osteological study of 1138 knees, standardized measurements of PCO and PTS were taken using previously described techniques on specimens of different age, race, and gender. Multiple linear regression was performed to determine the independent predictors of medial and lateral PTS.
Mean standardized medial PCO was greater than lateral PCO (1.22 ± 0.16 vs 1.15 ± 0.19 mm, P < .001) and medial PTS was greater than lateral PTS (7.3 ± 3.8° vs 5.7 ± 3.7°, P < .001). Decreasing PCO, female gender, and African-American race were associated with both increased medial and lateral PTS. Neither age nor femoral length correlated with medial or lateral PTS.
These data are the first to quantify that an inverse correlation between PCO and PTS exists. This relationship represents an important area for future biomechanical and clinical studies.
后髁偏移(PCO)和胫骨后倾(PTS)在全膝关节置换术中具有关键影响,尤其是在矢状面平衡方面。然而,对二者各自功能影响的研究有限,关于PCO与PTS之间的关联也仅有一些零星观察。
在一项对1138个膝关节的大型骨学研究中,采用先前描述的技术,对不同年龄、种族和性别的标本进行PCO和PTS的标准化测量。进行多元线性回归以确定内侧和外侧PTS的独立预测因素。
平均标准化内侧PCO大于外侧PCO(1.22±0.16对1.15±0.19毫米,P<.001),内侧PTS大于外侧PTS(7.3±3.8°对5.7±3.7°,P<.001)。PCO降低、女性性别和非裔美国人种族与内侧和外侧PTS增加均相关。年龄和股骨长度与内侧或外侧PTS均无相关性。
这些数据首次量化了PCO与PTS之间存在负相关。这种关系是未来生物力学和临床研究的一个重要领域。