Perth Hip and Knee Clinic, Subiaco, Australia.
St John of God Subiaco Hospital, Subiaco, Australia.
Comput Assist Surg (Abingdon). 2022 Dec;27(1):35-40. doi: 10.1080/24699322.2022.2078738.
Our aim was to understand whether using different landmarks for tibial component rotation influenced articular contact pressures in a balanced total knee arthroplasty (TKA). Twelve patients underwent TKA (Triathlon CR, Stryker Inc., Mahwah, NJ) and contact pressures were assessed using a wireless sensor. Robotic arm assisted TKA using a functional alignment technique was performed, with balanced gaps between medial and lateral compartments. Compartment pressures were measured with the trial tibial component rotated to Akagi's line and to Insall's axis respectively. Rotating the tibial component to Akagi's line resulted in a significantly greater proportion of knees being balanced and lower contact pressures than when the tibial component was rotated to Insall's axis at 10°, 45° and 90° of flexion ( < 0.05). Medial compartment pressures were significantly increased in 10° of flexion, as were lateral compartment pressures in all positions when the tibial component was aligned to Insall's axis ( < 0.05). The mean difference in rotation observed with the two landmarks was 6.9° (range 4.1-9.1°). Rotational alignment of the tibial component using Akagi's line reduced contact pressures, improved balance and reduced the need for soft tissue release when compared with Insall's axis in robotic arm assisted TKA.
我们的目的是了解胫骨组件旋转使用不同的标志是否会影响平衡全膝关节置换术（TKA）中的关节接触压力。 12 名患者接受了 TKA（Triathlon CR，Stryker Inc.，Mahwah，NJ），并使用无线传感器评估了接触压力。使用功能对准技术进行了机器人辅助 TKA，内侧和外侧间隔之间具有平衡的间隙。在分别将试配胫骨组件旋转至 Akagi 线和 Insall 轴的情况下，测量了间隔压力。与胫骨组件旋转至 Insall 轴在 10°，45°和 90°时相比，胫骨组件旋转至 Akagi 线可使更大比例的膝关节平衡且接触压力更低（<0.05）。在 10°的屈曲时，内侧间隔压力明显增加，而当胫骨组件与 Insall 轴对准时，所有位置的外侧间隔压力均升高（<0.05）。两种标志之间观察到的旋转平均差异为 6.9°（范围为 4.1-9.1°）。与 Insall 轴相比，在机器人辅助 TKA 中使用 Akagi 线进行胫骨组件的旋转对准可降低接触压力，改善平衡并减少软组织松解的需要。
