后胫骨倾斜对后交叉韧带保留型全膝关节置换术后前后稳定性的影响。
The effect of posterior tibial slope on anteroposterior stability in posterior cruciate retaining total knee arthroplasty.
机构信息
Istanbul Haseki Training and Research Hospital, Fatih/İstanbul, Türkiye.
Istanbul Faculty of Medicine, İstanbul University, Fatih/İstanbul, Türkiye.
出版信息
BMC Musculoskelet Disord. 2023 May 16;24(1):390. doi: 10.1186/s12891-023-06507-6.
BACKGROUND
It has been suggested that the posterior tibial slope (PTS) plays an important role in increasing the anteroposterior stability following total knee arthroplasty. Although the relationship between the PTS and the flexion range has been investigated many times, studies on the relationship between PTS and anterior-posterior stability are limited. The primary aim of this study was to investigate the relationship and effects of PTS on anteroposterior stability in posterior cruciate retainer total knee arthroplasty.
METHODS
154 primary TKAs were identified retrospectively to analyze the any association between PTS and anteroposterior laxity following posterior cruciate-retaining total knee arthroplasty in the overall study populations. Anteroposterior displacement was measured at the final follow-up based on the following two procedures: KT-1000 arthrometer and sagittal drawer radiographic images. In addition, the relationship between PTS and functional scores-ROM was examined.
RESULTS
There was no correlation between patients' posterior tibial slope and postoperative VAS (r: -0.060, p:0.544), WOMAC (r:0.037, p:0.709), KSS (r: -0.073, p:0.455). In addition, there was no significant correlation between postoperative knee ROM and postoperative PTS (r:0.159, p:0.106). Moreover, no correlation was found between KT-1000 arthrometer and 20 degrees AP translation with PTS. There was a negative correlation between PTS and 70 degrees AP translation (r: -0.281, p:0.008).
CONCLUSIONS
This study aimed to clarify the association between instability and AP laxity in flexion of implanted knees, and to determine what degree of AP laxity results of instability. A fundamental finding of this study was that; the optimum TS angle to increase anterior-posterior stability after total knee arthroplasty is between ≥ 4 to < 6 degrees, we also proved that there is no relationship between stability and patient satisfaction.
背景
有人认为胫骨后倾角（PTS）在后交叉韧带保留型全膝关节置换术后增加前后稳定性方面起着重要作用。尽管已经多次研究 PTS 与屈曲范围之间的关系，但 PTS 与前后稳定性之间关系的研究有限。本研究的主要目的是探讨 PTS 与后交叉韧带保留型全膝关节置换术后前后稳定性的关系及其影响。
方法
回顾性分析了 154 例初次 TKA，以分析后交叉韧带保留型全膝关节置换术后总体研究人群中 PTS 与前后松弛度的任何相关性。根据以下两种程序测量终末随访时的前后移位：KT-1000 关节测量仪和矢状位抽屉 X 线片。此外，还检查了 PTS 与功能评分-ROM 的关系。
结果
患者的后胫骨斜率与术后 VAS（r：-0.060，p：0.544）、WOMAC（r：0.037，p：0.709）、KSS（r：-0.073，p：0.455）无相关性。此外，术后膝关节 ROM 与术后 PTS 无显著相关性（r：0.159，p：0.106）。此外，KT-1000 关节测量仪与 PTS 之间无明显相关性。PTS 与 20 度 AP 平移之间存在负相关（r：-0.281，p：0.008）。
结论
本研究旨在阐明植入膝关节屈曲时不稳定与 AP 松弛之间的关系，并确定导致不稳定的 AP 松弛程度。本研究的一个基本发现是，全膝关节置换术后增加前后稳定性的最佳 TS 角度在≥4 到<6 度之间，我们还证明了稳定性与患者满意度之间没有关系。
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