Department of Orthopaedics, St. Vincent's Hospital (Melbourne), Fitzroy, Victoria, Australia; Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.
Department of Orthopaedics, St. Vincent's Hospital (Melbourne), Fitzroy, Victoria, Australia.
J Arthroplasty. 2018 Jan;33(1):75-78. doi: 10.1016/j.arth.2017.08.021. Epub 2017 Aug 24.
Gap balancing (GB) has been noted to sacrifice joint-line maintenance to improve gap symmetry. This study aims to determine whether this change affects function or quality of life in the midterm.
A prospective blinded randomized controlled trial was completed with 103 patients randomized to measured resection (n = 52) or GB (n = 51). Primary outcome measured was femoral component rotation. Secondary outcomes measured were joint-line change, gap symmetry, and function and quality-of-life outcomes.
At 5 years, 83 of 103 patients (85%) were assessed. There was no significant difference between groups in terms of functional or quality of life outcomes. A subgroup analysis revealed that there was no significant association between those with asymmetrical flexion and/or extension or medial and/or lateral gaps during knee replacement and subsequent functional outcomes. No significant difference was detected with those with an elevated joint line and postoperative function.
In the midterm, the resultant change in joint-line and maintained gap symmetry noted with GB does not result in significant change to function or quality of life.
间隙平衡（GB）已被注意到为了改善间隙对称性而牺牲关节线的维持。本研究旨在确定这种变化是否会对中期的功能或生活质量产生影响。
完成了一项前瞻性、盲法、随机对照试验，共纳入 103 例患者，随机分为测量切除组（n=52）或 GB 组（n=51）。主要观察指标为股骨组件旋转。次要观察指标为关节线变化、间隙对称性以及功能和生活质量结果。
5 年后，对 103 例患者中的 83 例（85%）进行了评估。两组在功能或生活质量结果方面无显著差异。亚组分析显示，膝关节置换术中存在屈伸间隙不对称和/或内外侧间隙不对称的患者与术后功能之间没有显著关联。关节线升高和术后功能正常的患者之间也未发现显著差异。
在中期，GB 导致的关节线位置变化和保持的间隙对称性不会导致功能或生活质量显著改变。
