Hooper Jessica M, Walker Peter, Hsu Tzu-Ting, Kurtz Anton, Reynolds Ryan, Hennessy Daniel, Chu Alice
Department of Orthopaedic Surgery, NYU Langone Medical Center's Hospital for Joint Diseases, New York, New York.
Department of Orthopaedic Surgery, Laboratory for Orthopaedic Implant Design, New York, New York.
J Knee Surg. 2018 Sep;31(8):761-766. doi: 10.1055/s-0037-1608821. Epub 2017 Nov 28.
Surgical correction of multiapical deformities of the lower limb requires careful preoperative planning. Surgeons must account for the potential creation of secondary deformity, such as knee joint line obliquity, and the risks associated with accepting these changes in limb alignment. In this study, we evaluate the effect of knee joint obliquity on tibial plateau contact pressures and knee instability. Three cadaveric knees were dissected and put through biomechanical testing to simulate loading of an oblique knee joint. We observed < 1 mm femoral displacement (proxy measure of instability) between 15 degrees of varus tilt and 10 degrees of valgus tilt, and greater increases in tibial plateau contact pressures with valgus tilt than with varus tilt. Our results suggest that, if the creation of a secondary coronal plane deformity at the knee joint cannot be avoided, up to 15 degrees of varus or 10 degrees of valgus alignment can be tolerated by an otherwise structurally normal knee.
下肢多根尖畸形的手术矫正需要仔细的术前规划。外科医生必须考虑到继发性畸形的潜在产生，例如膝关节线倾斜，以及接受肢体对线这些变化所带来的风险。在本研究中，我们评估了膝关节倾斜对胫骨平台接触压力和膝关节不稳定的影响。解剖了三个尸体膝关节并进行生物力学测试，以模拟倾斜膝关节的负荷。我们观察到，在15度内翻倾斜和10度外翻倾斜之间，股骨位移（不稳定的替代指标）小于1毫米，并且外翻倾斜时胫骨平台接触压力的增加幅度大于内翻倾斜时。我们的结果表明，如果无法避免在膝关节处产生继发性冠状面畸形，对于结构上正常的膝关节，可耐受高达15度的内翻或10度的外翻对线。
