Seo Seung-Suk, Kim Chang-Wan, Seo Jin-Hyuk, Kim Do-Hun, Kim Ok-Gul, Lee Chang-Rack
Department of Orthopedic Surgery, Bumin Hospital, Buk-gu, Busan, Republic of Korea.
Department of Orthopedic Surgery, Busan Paik Hospital, College of Medicine, Inje University, Busanjin-gu, Busan, Republic of Korea.
J Arthroplasty. 2017 Jun;32(6):1819-1823. doi: 10.1016/j.arth.2017.01.042. Epub 2017 Feb 1.
When evaluating the effects of the preparation of the flexion gap on the extension gap in total knee arthroplasty (TKA), the effects of posterior condylar resection and osteophyte removal on the extension gap should be differentiated. Although the amount of osteophytes differs between patients, posterior condylar resection is a procedure that is routinely implemented in TKA. The aim of this study was to assess the effects of the resection of the posterior condyle of the femur on the extension gap in posterior-stabilized (PS) TKA.
We enrolled 40 knees that underwent PS TKA between July 2010 and February 2011 with no or minimal osteophytes in the posterior compartment and a varus deformity of <15°. We measured the extension gap before and after the resection of the posterior condyle of the femur using a tensor under 20 and 40 lb of distraction force.
Under 20 lb of distraction force, the average extension gap was 13.3 mm (standard deviation [SD], 1.6) before and 13.8 mm (SD, 1.6) after posterior condylar resection. Under 40 lb of distraction force, the average extension gap was 15.1 mm (SD, 1.5) before and 16.1 mm (SD, 1.7) after posterior condylar resection.
The resection of the posterior condyle of the femur in PS TKA increased the extension gap. However, this increase was only by approximately 1 mm. In conclusion, posterior condylar resection does increase the extension gap by approximately 1 mm. However, in most case, this change in unlikely to be clinically important.
在评估全膝关节置换术(TKA)中屈曲间隙准备对伸直间隙的影响时,应区分后髁切除和骨赘清除对伸直间隙的影响。尽管患者之间的骨赘量有所不同,但后髁切除是TKA中常规实施的操作。本研究的目的是评估股骨后髁切除对后稳定型(PS)TKA伸直间隙的影响。
我们纳入了2010年7月至2011年2月期间接受PS TKA的40个膝关节,这些膝关节后关节腔无或仅有极少骨赘,内翻畸形<15°。我们使用张力器在20磅和40磅牵张力下测量股骨后髁切除前后的伸直间隙。
在20磅牵张力下,后髁切除前平均伸直间隙为13.3毫米(标准差[SD],1.6),切除后为13.8毫米(SD,1.6)。在40磅牵张力下,后髁切除前平均伸直间隙为15.1毫米(SD,1.5),切除后为16.1毫米(SD,1.7)。
PS TKA中股骨后髁切除增加了伸直间隙。然而,这种增加仅约1毫米。总之,后髁切除确实使伸直间隙增加了约1毫米。然而,在大多数情况下,这种变化在临床上不太可能具有重要意义。