Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Knee. 2022 Oct;38:69-75. doi: 10.1016/j.knee.2022.07.012. Epub 2022 Aug 2.
JOURNEY II bi-cruciate stabilized (BCS) knee system, a guided motion total knee arthroplasty (TKA), has been reported to reproduce physiological knee kinematic motion with good clinical outcomes. However, this guided system may be sensitive to the femorotibial rotational alignment.
Forty-four patients (50 knees) who underwent JOURNEY II BCS TKA were included in this retrospective study. The 2011 Knee Society Score (KSS) and range of motion were assessed pre-operatively and one year postoperatively. The femoral component rotational angle relative to the surgical epicondylar axis and the tibial component rotational angle relative to Akagi's line were measured postoperatively. The absolute difference between the femoral and tibial component rotational angles was defined as femorotibial component rotational mismatch. The correlation between the parameters of these rotational alignments and postoperative clinical outcomes was evaluated. Additionally, receiver operating characteristic curve analysis was performed to determine the optimal cut-off point of the femorotibial component rotational mismatch.
Mean femoral and tibial component rotational angles were 0.4° (internal rotation) and 0.7° (external rotation), respectively. The rotational mismatch of the femorotibial component was 3.2°. There were negative correlations between femorotibial rotational mismatch and clinical outcomes, including objective knee indicators, patient satisfaction, functional activities, and total 2011 KSS. The area under the curve of the femorotibial component rotational mismatch was 0.768 and the cut-off value identified by the Youden index was 2.8°.
Excessive rotational mismatch between the femoral and tibial components can negatively influence the clinical outcomes of JOURNEY II BCS TKA.
Journey II 双十字韧带稳定（BCS）膝关节系统是一种引导运动的全膝关节置换术（TKA），已被报道可复制生理性膝关节运动学运动，并取得良好的临床效果。然而，这种引导系统可能对股胫旋转对线敏感。
本回顾性研究纳入了 44 例（50 膝）接受 Journey II BCS TKA 的患者。术前和术后 1 年评估 2011 年膝关节学会评分（KSS）和活动范围。测量术后股骨组件相对于手术髁上轴的旋转角度和胫骨组件相对于 Akagi 线的旋转角度。股骨和胫骨组件旋转角度之间的绝对差值定义为股胫组件旋转不匹配。评估这些旋转对线参数与术后临床结果的相关性。此外，还进行了受试者工作特征曲线分析，以确定股胫组件旋转不匹配的最佳截断点。
平均股骨和胫骨组件旋转角度分别为 0.4°（内旋）和 0.7°（外旋）。股胫组件的旋转不匹配为 3.2°。股胫旋转不匹配与临床结果呈负相关，包括客观膝关节指标、患者满意度、功能活动和总 2011 KSS。股胫组件旋转不匹配的曲线下面积为 0.768，Youden 指数确定的截断值为 2.8°。
股骨和胫骨组件之间过大的旋转不匹配会对 Journey II BCS TKA 的临床结果产生负面影响。
