Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima, Osaka, Osaka, 534-0021, Japan.
Arch Orthop Trauma Surg. 2022 Jul;142(7):1653-1659. doi: 10.1007/s00402-021-04017-5. Epub 2021 Jul 5.
The relationship between gap balancing and clinical outcome of total knee arthroplasty (TKA) has been researched. Tourniquet is widely used by most surgeons; however, there are little quantitative data about the gap depending on the tourniquet usage. We aimed to investigate whether the knee position at tourniquet inflation affected the gap measurement intra-operatively.
TKA was performed for 104 knees and the tourniquet was inflated with the knee at full flexion and extension. The gap was measured in each static knee flexion status (0°, 30°, 45°, 60°, 90°, 120°, and in full flexion) using a tensor. We measured the gap twice; under the tourniquet inflation and release. The gap difference at each static knee flexion status was calculated by subtracting the gap under release from that under inflation.
When the tourniquet was inflated with the knee at full flexion, the mean gap differences were < 1 mm and < 1° in each static knee flexion status. When the tourniquet was inflated with the knee at full extension, the mean gap differences were < 1 mm and < 1°, respectively. All values of the gap difference were minimum, and were not affected by the tourniquet, whether the knee position at the tourniquet inflation was flexed or extended.
We postulated that the knee position at tourniquet inflation would affect the gap, which was refuted by our results. This shows that we can measure the gap without considering the knee position at tourniquet inflation.
全膝关节置换术（TKA）的间隙平衡与临床结果之间的关系已被研究。大多数外科医生广泛使用止血带；然而，关于使用止血带时的间隙的定量数据很少。我们旨在研究止血带充气时膝关节的位置是否会影响术中间隙测量。
对 104 例膝关节进行 TKA，止血带充气时膝关节处于完全伸直和完全屈曲状态。使用张力计测量每个静态膝关节屈曲状态（0°、30°、45°、60°、90°和完全屈曲）下的间隙。我们测量了两次间隙；在止血带充气和释放下。通过从充气下的间隙中减去释放下的间隙来计算每个静态膝关节屈曲状态下的间隙差异。
当膝关节在完全屈曲状态下充气时，在每个静态膝关节屈曲状态下，平均间隙差异均小于 1 毫米和小于 1°。当膝关节在完全伸展状态下充气时，平均间隙差异分别小于 1 毫米和小于 1°。间隙差异的所有值均最小，不受止血带影响，无论止血带充气时膝关节的位置是伸直还是屈曲。
我们假设止血带充气时膝关节的位置会影响间隙，这与我们的结果相矛盾。这表明我们可以在不考虑止血带充气时膝关节位置的情况下测量间隙。
