Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan.
BMC Musculoskelet Disord. 2022 May 26;23(1):496. doi: 10.1186/s12891-022-05464-w.
In bicruciate-stabilized total knee arthroplasty (BCS-TKA), the relationship between the postoperative kinematics and sports subscales in patient-reported outcome measures (PROMs) remains unknown. The purpose of this study was to determine the relationship between kinematics and sports subscales using the PROMs after BCS-TKA.
Sixty-one patients with severe knee osteoarthritis were examined at 13.5 ± 7.8 months after BCS-TKA. The patients performed squats under single fluoroscopic surveillance in the sagittal plane. Range of motion of the knee, axial rotation of the femur relative to the tibial component, and anteroposterior (AP) translation of the medial and lateral femorotibial contact points were measured using a 2D-to-3D registration technique. In addition, the relationship between the kinematics and improvement of the sports subscales in the Knee Injury and Osteoarthritis Outcome Score (KOOS) was evaluated.
In rotation angle, the femoral external rotation was observed from 0 to 50° of flexion. The amount of femoral external rotation did not correlate with PROMs-SP. In medial AP translation, posterior translation was observed from 0 to 20° and 80-110° of flexion. Mild anterior translation was observed from 20 to 80° of flexion. Beyond 80° of flexion, posterior translation was positively correlated with squatting. In lateral AP translation, posterior translation was observed from 0 to 20° and 80-110° of flexion. Beyond 80° of flexion, posterior translation was positively correlated with running, jumping, twisting/pivoting, and kneeling.
Femoral rollback at high flexion during squatting may be important to improve sports performance after BCS-TKA.
在双交叉韧带稳定型全膝关节置换术（BCS-TKA）中，术后运动学与患者报告的结局测量（PROMs）中的运动学亚量表之间的关系尚不清楚。本研究旨在通过 BCS-TKA 后的 PROMs 来确定运动学与运动学亚量表之间的关系。
61 例严重膝关节骨关节炎患者在 BCS-TKA 后 13.5±7.8 个月接受检查。患者在矢状面下接受单次荧光透视监测进行深蹲。使用二维到三维配准技术测量膝关节活动度、股骨相对于胫骨组件的轴向旋转以及内侧和外侧股骨胫骨接触点的前后（AP）平移。此外，还评估了 Knee Injury and Osteoarthritis Outcome Score（KOOS）中运动学与运动学亚量表改善之间的关系。
在旋转角度方面，从 0 到 50°的屈曲过程中观察到股骨外旋。股骨外旋量与 PROMs-SP 不相关。在 AP 内侧平移方面，从 0 到 20°和 80-110°的屈曲过程中观察到后移。从 20°到 80°的屈曲过程中观察到轻微的前移位。超过 80°的屈曲后，后移与深蹲呈正相关。在 AP 外侧平移方面，从 0 到 20°和 80-110°的屈曲过程中观察到后移。超过 80°的屈曲后，后移与跑步、跳跃、扭转/枢转和跪地呈正相关。
深蹲时在高屈曲位的股骨后滚可能对 BCS-TKA 后改善运动表现很重要。
