Teeter Matthew G, Perry Kevin, Yuan Xunhua, Howard James L, Lanting Brent A
Department of Orthopaedic Surgery, London Health Sciences Centre University Hospital, London, Ontario, Canada.
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.
J Knee Surg. 2020 Jan;33(1):78-83. doi: 10.1055/s-0038-1676462. Epub 2018 Dec 18.
The purpose of the present study was to measure the effects of gap balancing and resection techniques on migration of a single total knee replacement implant design. A total of 23 patients (24 knees) were recruited on referral to either a surgeon performing gap balancing or a surgeon performing measured resection and followed prospectively. All patients received a fixed bearing, posterior stabilized total knee replacement implant of a single radius femoral component design with cement fixation, and all aspects of care outside of resection technique were identical. Patients underwent radiostereometric analysis (RSA) at 2 weeks (baseline), 6 weeks, 3 months, 6 months, 1 year, and 2 years. Migration of the tibial and femoral components was compared between groups. Tibial component migration was greater at 2 years in the gap balancing group (mean difference = 0.336 mm, = 0.036), but there was no difference at 1 year. One measured resection and three gap balancing tibial components demonstrated continuous migration > 0.2 mm between years 1 and 2. There was no difference in femoral component migration. Small differences in tibial component migration were found between the gap balancing and measured resection techniques. However, comparing the migration to established predictive thresholds for long-term loosening risk, implants performed with both techniques were found to have equally low revision risk.
本研究的目的是测量间隙平衡和截骨技术对单一全膝关节置换植入物设计移位的影响。总共招募了23名患者（24个膝关节），他们被转介给进行间隙平衡的外科医生或进行测量截骨的外科医生，并进行前瞻性随访。所有患者均接受了带骨水泥固定的单一半径股骨组件设计的固定平台、后稳定型全膝关节置换植入物，除截骨技术外的所有护理方面均相同。患者在2周（基线）、6周、3个月、6个月、1年和2年时接受放射立体测量分析（RSA）。比较两组之间胫骨和股骨组件的移位情况。间隙平衡组在2年时胫骨组件的移位更大（平均差异=0.336mm，P=0.036），但在1年时没有差异。1个测量截骨和3个间隙平衡的胫骨组件在第1年和第2年之间显示出持续移位>0.2mm。股骨组件的移位没有差异。间隙平衡和测量截骨技术之间在胫骨组件移位方面存在微小差异。然而，将移位与既定的长期松动风险预测阈值进行比较时，发现两种技术植入的假体具有同样低的翻修风险。
