Moser Lukas B, Prabhakar Ponnaian, Hess Silvan, Hirschmann Michael T
Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Bruderholz, CH-4101 Basel, Switzerland.
Research Group Michael T. Hirschmann, Regenerative Medicine & Biomechanics, Department of Clinical Research, University of Basel, CH-4001 Basel, Switzerland.
Clin Pract. 2021 Sep 18;11(3):687-693. doi: 10.3390/clinpract11030084.
A posterior flexion instability due to insufficiency of the posterior cruciate ligament (PCL) in cruciate retaining (CR) total knee arthroplasty (TKA) is an important but underdiagnosed problem. We hereby suggest a diagnostic algorithm, as demonstrated by a case report of a male patient suffering from anterior knee pain and instability after CR TKA. Clinical examination was followed by standard anterior-posterior and lateral radiographs. Stress radiographs in 30° and 90° posterior drawer position enabled a dynamic examination of the instability. SPECT/CT was used to determine the TKA component position in all planes and investigate bone tracer uptake (BTU) patterns. At revision surgery, an absent PCL after CR TKA was noted and a semi-constrained TKA was implanted.
在保留交叉韧带的全膝关节置换术（CR-TKA）中，由于后交叉韧带（PCL）功能不全导致的后屈不稳定是一个重要但诊断不足的问题。在此，我们通过一名男性患者在CR-TKA术后出现前膝疼痛和不稳定的病例报告，提出一种诊断算法。临床检查后进行标准的前后位和侧位X线片检查。在30°和90°后抽屉位的应力X线片能够对不稳定进行动态检查。SPECT/CT用于确定CR-TKA组件在所有平面的位置，并研究骨显像剂摄取（BTU）模式。在翻修手术中，发现CR-TKA术后PCL缺失，并植入了半限制性TKA。
