Orthopedic Institute of Wisconsin, Milwaukee, WI.
Colorado Joint Replacement, Porter Adventist Hospital, Denver, CO.
J Arthroplasty. 2018 Jul;33(7S):S116-S120. doi: 10.1016/j.arth.2018.02.018. Epub 2018 Feb 15.
Some patients perceive symptomatic improvement in the contralateral knee after unilateral total knee arthroplasty (TKA). This so-called "splinting effect" has been observed but has not been radiographically evaluated.
A retrospective review of patients with bilateral knee osteoarthritis treated with unilateral TKA was performed. Patients were subcategorized into 2 groups based on whether contralateral TKA was performed within the 2-year period. Contralateral radiographic measurements were performed.
Forty-four of 203 patients had contralateral TKA performed within 2 years. Preoperative parameters were significantly worse in the bilateral group. By 6 weeks postoperatively, mechanical axis plumbline improved approximately 1°, with more change in those patients with preoperative varus alignment. Larger delta changes were also present in bilateral group preoperative to 1-year radiographs for tibiofemoral angle and joint space widening.
In patients with bilateral knee osteoarthritis who undergo unilateral TKA, a splinting effect may be present and measurable radiographically with improvement of contralateral mechanical axis plumbline. Further research is necessary to determine whether this improvement may delay contralateral TKA implantation.
一些患者在单侧全膝关节置换术后（TKA）对其对侧膝关节的症状改善有感知。这种所谓的“夹板效应”已被观察到，但尚未进行影像学评估。
对接受单侧 TKA 治疗的双侧膝关节骨关节炎患者进行回顾性研究。根据对侧 TKA 是否在 2 年内进行，将患者分为 2 组。对侧进行放射学测量。
203 例患者中有 44 例在 2 年内进行了对侧 TKA。双侧组的术前参数明显较差。术后 6 周时，机械轴铅垂线改善约 1°，术前存在内翻畸形的患者变化更大。在双侧组中，术前至 1 年的放射学检查中，胫骨股骨角和关节间隙增宽的 delta 变化也更大。
在接受单侧 TKA 的双侧膝关节骨关节炎患者中，可能存在夹板效应，并且可以通过改善对侧机械轴铅垂线来进行影像学测量。需要进一步研究以确定这种改善是否可能延迟对侧 TKA 植入。
