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胫骨后倾对保留后交叉韧带的全膝关节置换术后运动学的影响。

Influence of Posterior Tibial Slope on Kinematics After Cruciate-Retaining Total Knee Arthroplasty.

机构信息

Department of Orthopaedic Biomaterial Science, Osaka University, Graduate School of Medicine, Suita, Osaka, Japan.

Department of Information Systems, Saitama Institute of Technology, Fukaya, Saitama, Japan.

出版信息

J Arthroplasty. 2018 Dec;33(12):3778-3782.e1. doi: 10.1016/j.arth.2018.07.029. Epub 2018 Aug 13.

DOI:10.1016/j.arth.2018.07.029
PMID:30195655
Abstract

BACKGROUND

The purpose of this study was to investigate the influence of posterior tibial slope (PTS) on knee kinematics after cruciate-retaining total knee arthroplasty (CR-TKA). These influences were evaluated using a prosthesis designed with high geometric conformity to the medial articular surface under the weight-bearing condition of deep knee bending.

METHODS

We evaluated 71 knees (52 patients) after CR-TKA using 2- to 3-dimensional registration techniques. All patients were categorized into 2 groups: group A (PTS ≤ 7°) and group B (PTS ≥ 8°). We compared in vivo knee kinematics during deep knee bending under weight-bearing conditions between the 2 groups. The anteroposterior position of the nearest points, flexion angles, and external rotation angles of the femoral components relative to the tibial components were evaluated. Additionally, the knee flexion angles of the femur relative to the tibia obtained from the installation angles of the components were evaluated.

RESULTS

PTS did not affect the external rotation angles and anteroposterior position. The postoperative maximum flexion angle and range of motion between the femur and tibia in group B were significantly greater than those in group A.

CONCLUSION

PTS of 8° or more in CR-TKA using prosthetics designed with high geometric conformity to the medial articular surface did not affect the anteroposterior position and external rotation, but increased the postoperative maximum flexion angle and range of motion.

摘要

背景

本研究旨在探讨保留后交叉韧带的全膝关节置换术后胫骨后倾角(PTS)对膝关节运动学的影响。在负重状态下,采用与内侧关节面具有高度几何匹配的假体对这些影响进行评估,在深度屈膝状态下。

方法

我们使用 2-3 维配准技术评估了 71 例(52 例患者)CR-TKA 后的膝关节。所有患者分为两组:A 组(PTS≤7°)和 B 组(PTS≥8°)。我们比较了两组患者在负重状态下深度屈膝时的膝关节运动学。评估了股骨组件相对于胫骨组件的最接近点的前后位置、屈曲角度和外旋角度。此外,还评估了从组件安装角度获得的股骨相对于胫骨的膝关节屈曲角度。

结果

PTS 对外旋角度和前后位置没有影响。B 组术后最大屈曲角度和股骨与胫骨之间的运动范围明显大于 A 组。

结论

在使用与内侧关节面具有高度几何匹配的假体进行 CR-TKA 时,PTS 为 8°或更大不会影响前后位置和外旋,但会增加术后最大屈曲角度和运动范围。

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