Radhamony Niranj G, Chaugule Anant, Bhende Harish S
Trauma and Orthopaedics, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, GBR.
Orthopaedics, Ortho One Orthopaedic Clinic, Sangli, IND.
Cureus. 2022 Sep 28;14(9):e29695. doi: 10.7759/cureus.29695. eCollection 2022 Sep.
Background Posterior tibial slope (PTS) is one of the factors that determine the postoperative range of movement (ROM) in total knee replacement (TKR). While biomechanical factors influencing ROM such as PTS, soft-tissue balancing, and choice of implants are surgeon-dependent, non-biomechanical factors such as physiotherapy and pain are subjective and beyond the surgeon's control. Using navigation, we avoided these factors and objectively correlated the difference in PTS with ROM. Methodology A total of 120 cases of posteriorly stabilized (PS) TKR were included. The X-ray-measured difference in PTS was compared to the corresponding change in the ROM intraoperatively using the TKR navigation system. Based on the change in PTS, the cases were classified into three groups, and the intergroup variability of mean postoperative ROM, mediolateral laxity difference (MLD), and residual flexion (RF) was calculated. Results An average MLD of 1.39 mm in extension and 1.79 mm in flexion and an average RF of 3.18 degrees were seen. This uniformity neutralizes the effects of these factors on the ROM. The mean difference in the PTS in the three groups was 4.45, 10.76, and 17.98 degrees, and the mean change in the ROM was 3.07, 1.47, and 2.84 degrees, respectively. There was no statistically significant change in ROM with that of change in PTS. Conclusions In our study, it was shown statistically that the coronal and sagittal planes were uniformly balanced using navigation assistance, and the PTS and the postoperative ROM were the only variables. The correlated results showed that a change in the PTS does not affect the postoperative ROM in PS TKR using the implant system used in our study.
背景 胫骨后倾坡度（PTS）是决定全膝关节置换术（TKR）术后活动范围（ROM）的因素之一。虽然影响ROM的生物力学因素，如PTS、软组织平衡和植入物的选择，取决于外科医生，但诸如物理治疗和疼痛等非生物力学因素是主观的，超出了外科医生的控制范围。我们利用导航技术避免了这些因素，并客观地将PTS的差异与ROM进行关联。方法 共纳入120例后稳定型（PS）TKR病例。使用TKR导航系统，将X线测量的PTS差异与术中ROM的相应变化进行比较。根据PTS的变化，将病例分为三组，并计算术后平均ROM、内外侧松弛度差异（MLD）和残余屈曲（RF）的组间变异性。结果 伸直位平均MLD为1.39mm，屈曲位为1.79mm，平均RF为3.18度。这种一致性抵消了这些因素对ROM的影响。三组的PTS平均差异分别为4.45、10.76和17.98度，ROM的平均变化分别为3.07、1.47和2.84度。ROM随PTS变化无统计学显著变化。结论 在我们的研究中，统计学表明，在导航辅助下冠状面和矢状面得到均匀平衡，PTS和术后ROM是仅有的变量。相关结果表明，使用我们研究中所用的植入系统，PTS的变化不影响PS TKR术后的ROM。
