2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136, Bologna, Italy.
University of Bologna, Bologna, Italy.
Knee Surg Sports Traumatol Arthrosc. 2021 Feb;29(2):491-497. doi: 10.1007/s00167-020-05975-w. Epub 2020 Apr 6.
To evaluate if there was a correlation between in vivo kinematics of a medial-stabilized (MS) total knee arthroplasty (TKA) and post-operative clinical scores. We hypothesized that (1) a MS-TKA would produce a medial pivot movement and that (2) this specific pattern would be correlated with higher clinical scores.
18 patients were evaluated through clinical and functional scores evaluation (Knee Society Score clinical and functional, Womac, Oxford), and kinematically through dynamic radiostereometric analysis (RSA) at 9 months after MS-TKA, during the execution of a sit-to-stand and a lunge motor task. The anteroposterior (AP) Low Point translation of medial and lateral femoral compartments was compared through Student's t test (p < 0.05). A correlation analysis between scores and kinematics was performed through the Pearson's correlation coefficient r.
A significantly greater (p < 0.0001) anterior translation of the lateral compartment with respect to the medial one was found in both sit-to-stand (medial 2.9 mm ± 0.7 mm, lateral 7.1 mm ± 0.6 mm) and lunge (medial 5.3 mm ± 0.9 mm, lateral 10.9 mm ± 0.7 mm) motor tasks, thus resulting in a medial pivot pattern in about 70% of patients. Significant positive correlation in sit-to-stand was found between the peak of AP translation in the lateral compartment and clinical scores (r = 0.59 for Knee Society Score clinical and r = 0.61 for Oxford). Moreover, we found that the higher peak of AP translation of the medial compartment correlated with lower clinical scores (r = - 0.55 for Knee Society Score clinical, r = - 0.61 for Womac and r = - 0.53 for Oxford) in the lunge. A negative correlation was found between Knee Society Score clinical and VV laxity during sit-to-stand (r = - 0.56) and peak of external rotation in the lunge motor task (r = - 0.66).
The MS-TKA investigated produced in vivo a medial pivot movement in about 70% of patients in both examined motor tasks. There was a correlation between the presence of medial pivot and higher post-operative scores.
IV.
评估内侧稳定型（MS）全膝关节置换术后（TKA）的体内运动学与术后临床评分之间是否存在相关性。我们假设（1）MS-TKA 将产生内侧枢轴运动，（2）这种特定模式与更高的临床评分相关。
18 名患者通过临床和功能评分评估（膝关节协会评分临床和功能、Womac、牛津大学）以及动态放射立体测量分析（RSA）进行评估，在接受 MS-TKA 后 9 个月，在进行坐站和弓步运动任务时。通过学生 t 检验比较内侧和外侧股骨间室的前后向（AP）低点平移（p < 0.05）。通过 Pearson 相关系数 r 对评分和运动学进行相关性分析。
在坐站（内侧 2.9 ± 0.7mm，外侧 7.1 ± 0.6mm）和弓步（内侧 5.3 ± 0.9mm，外侧 10.9 ± 0.7mm）运动任务中，外侧间室的前向平移明显大于内侧间室（p < 0.0001），从而导致约 70%的患者出现内侧枢轴模式。在坐站时，发现外侧间室 AP 平移峰值与临床评分之间存在显著正相关（Knee Society Score 临床评分 r = 0.59，牛津大学评分 r = 0.61）。此外，我们发现内侧间室 AP 平移峰值越高，临床评分越低（Knee Society Score 临床评分 r = -0.55，Womac 评分 r = -0.61，牛津大学评分 r = -0.53）在弓步中。在坐站时，Knee Society Score 临床评分与 VV 松弛度之间存在负相关（r = -0.56），在弓步运动任务中，外旋峰值与负相关（r = -0.66）。
在所研究的两种运动任务中，接受 MS-TKA 的患者中约有 70%出现体内内侧枢轴运动。存在内侧枢轴与术后评分较高相关。
IV。
