Department of Orthopedic Surgery, Shiroi Seijinkai Hospital, 3-25-2 Sasazuka, Shiroi-shi, Chiba, 270-1426, Japan.
Digital Human Research Team, Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan.
BMC Musculoskelet Disord. 2021 Mar 23;22(1):298. doi: 10.1186/s12891-021-04175-y.
Patellofemoral complications are one of the major issues after total knee arthroplasty (TKA). Excessive patellofemoral joint pressure is associated with complications after TKA surgery, and the amount of patellar osteotomy has a direct effect on patellofemoral joint pressure. The purpose of this study was to evaluate the influence of patella thickness on patellofemoral pressure in TKA.
Five freshly frozen cadavers were operated with a custom-made Stryker posterior stabilizing type knee joint prosthesis. Patellofemoral joint pressure was measured using a pressure sensor, with the knee joint flexed from 90 to 110 degrees, and with patellar thickness of - 2 mm to + 4 mm.
Increasing or decreasing patellar thickness significantly increased or decreased patellofemoral pressure. Regarding knee flexion angle, patellofemoral pressure increased with increasing patellar thickness at all flexion angles, but the pressure increase was greatest at 90 degrees of knee flexion and smallest at 110 degrees.
The amount of patellar osteotomy influences the patellofemoral pressure. Surgeons should avoid increasing patella thickness, since the resulting increased patellofemoral pressure may reduce knee joint function.
髌股关节并发症是全膝关节置换术（TKA）后主要问题之一。髌股关节压力过大与 TKA 手术后的并发症有关，而髌骨截骨量直接影响髌股关节压力。本研究旨在评估髌骨厚度对 TKA 中髌股压力的影响。
使用定制的史赛克后稳定型膝关节假体对 5 具新鲜冷冻尸体进行手术。在膝关节从 90 度到 110 度弯曲的情况下，使用压力传感器测量髌股关节压力，髌骨厚度为-2mm 至+4mm。
增加或减少髌骨厚度会显著增加或降低髌股压力。关于膝关节弯曲角度，随着髌骨厚度的增加，髌股压力在所有弯曲角度下都增加，但在 90 度膝关节弯曲时增加最大，在 110 度时最小。
髌骨截骨量影响髌股压力。外科医生应避免增加髌骨厚度，因为由此导致的髌股压力增加可能会降低膝关节功能。
