Akça Mustafa Çınar, Akalın Yavuz, Çevik Nazan, Şahin İsmail Gökhan, Avcı Özgür, Öztürk Alpaslan
Research and Training Hospital Clinic of Orthopaedics and Traumatology, Health Sciences University Bursa YuksekIhtisas, 16310, Yildirim, Bursa, Turkey.
Clinic of Orthopaedics and Traumatology, Turkish Ministry of Health, Edirne Sultan 1 Murat State Hospital, Edirne, Turkey.
Arthroplasty. 2020 Sep 14;2(1):27. doi: 10.1186/s42836-020-00046-4.
In this study, the traditional "Anatomical Landmark-Distance Method (AL-DM)" in the formation of joint line (JL) was compared with "Adductor Tubercle-Ratios method" (AT-RM), and the effect of reestablishment of JL on clinical and functional outcomes were evaluated.
16 revision total knee arthroplasties (rTKAs) were performed by using "AT-RM" (group 1) and 16 rTKA by using "AL-DM" (group 2) in our clinic between 2015 and 2018. The data were prospectively collected and a total of 32 knees of 31 patients were analyzed. At the final follow-up, knee functions were evaluated by using Knee Society Score (KSS) knee and function, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, Short Form-36 (SF-36) questionnaires and physical examinations.
Postoperative flexion arc was higher in Group 1. KSS knee and function scores were better in group 1. In group1, JL was reestablished successfully in all revision rTKAs in terms of ATJL and the tibial tubercle TT-JL ratios. The improvement in KSS knee and function scores and WOMAC scores were also better in group 1. Measurements showed that the improvement in KSS scores increased as AT-JL and TT-JL distances approached the calculated values.
"AT-RM" was shown to be superior to the traditional distance method in terms of JL reestablishment. Functional results and patient satisfaction increased when JL was reestablished.
在本研究中，将关节线（JL）形成过程中的传统“解剖标志-距离法（AL-DM）”与“内收肌结节-比率法”（AT-RM）进行比较，并评估JL重建对临床和功能结果的影响。
2015年至2018年期间，在我们诊所对16例翻修全膝关节置换术（rTKA）采用“AT-RM”（第1组），对16例rTKA采用“AL-DM”（第2组）。前瞻性收集数据，共分析31例患者的32个膝关节。在最后随访时，使用膝关节协会评分（KSS）的膝关节和功能评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、简明健康状况调查量表（SF-36）问卷以及体格检查来评估膝关节功能。
第1组术后屈曲弧度更高。第1组的KSS膝关节和功能评分更好。在第1组中，就ATJL和胫骨结节TT-JL比率而言，所有翻修rTKA的JL均成功重建。第1组中KSS膝关节和功能评分以及WOMAC评分的改善也更好。测量结果显示，随着AT-JL和TT-JL距离接近计算值，KSS评分的改善增加。
在JL重建方面，“AT-RM”被证明优于传统距离法。重建JL时，功能结果和患者满意度提高。
