Iriuchishima Takanori, Goto Bunsei
Department of Orthopedic Surgery, Kamimoku Spa Hospital, Minakami, Japan.
Musculoskelet Surg. 2025 Mar;109(1):41-46. doi: 10.1007/s12306-024-00849-7. Epub 2024 Jul 18.
The purpose of this study was to evaluate the anterior tibial translation (ATT) in the prone position after total knee arthroplasty (TKA).
Fifty subjects (50 knees) undergoing bi-cruciate substituting (BCS)-TKA (Journey II: Smith and Nephew) and age-gender matching 50 subjects (50 knees) undergoing posterior stabilizing (PS)-TKA, were included in this study. Approximately, six months after surgery, and when the subjects had recovered their range of knee motion, following the Mae's method, accurate lateral radiographic imaging of the knee was performed with full knee extension in both supine and prone positions. The maximal protrusion length of the femoral posterior component, posterior to the extension line parallel to the tibial shaft from the edge of the posterior tibial plateau, was measured on lateral radiographs. The difference in length between the prone and supine positions was regarded as the prone-ATT. The posterior protrusion length of the femoral component, and the prone-ATT were compared between BCS and PS-TKA.
The posterior protrusion length of the femoral component in the supine position was BCS-TKA 4.3 ± 1.9 mm, and PS-TKA 8.7 ± 2.3 mm. The length in the prone position was BCS-TKA 4.8 ± 2.3 mm, and PS-TKA 10.7 ± 2.2 m. Posterior protrusion length of the femoral component was significantly larger in both positions in PS-TKA when compared with BCS-TKA. In PS-TKA, posterior protrusion length of the femoral condyle was significantly larger in the prone position when compared to the supine position. No significant difference was observed in BCS-TKA. Prone-ATT was significantly larger in PS-TKA (2 ± 1.9 mm) when compared to BCS-TKA (0.7 ± 2 mm).
Even in a position corresponding to daily movement such as the prone position, ATT was significantly larger in PS-TKA, when compared to BCS-TKA.
本研究旨在评估全膝关节置换术（TKA）后俯卧位时的胫骨前移（ATT）情况。
本研究纳入了50例接受双交叉替代（BCS）-TKA（Journey II：史赛克公司）的受试者（50膝）以及年龄和性别匹配的50例接受后稳定型（PS）-TKA的受试者（50膝）。术后约6个月，当受试者恢复膝关节活动范围后，按照Mae氏方法，在仰卧位和俯卧位时均使膝关节完全伸直，对膝关节进行精确的侧位X线成像。在侧位X线片上测量股骨后髁组件从胫骨后平台边缘到与胫骨干平行的延长线后方的最大突出长度。俯卧位与仰卧位长度之差被视为俯卧位ATT。比较了BCS-TKA和PS-TKA之间股骨组件的后突出长度以及俯卧位ATT。
仰卧位时，BCS-TKA的股骨组件后突出长度为4.3±1.9mm，PS-TKA为8.7±2.3mm。俯卧位时，BCS-TKA的长度为4.8±2.3mm，PS-TKA为10.7±2.2mm。与BCS-TKA相比，PS-TKA在两个体位下股骨组件的后突出长度均显著更大。在PS-TKA中，与仰卧位相比，俯卧位时股骨髁的后突出长度显著更大。在BCS-TKA中未观察到显著差异。与BCS-TKA（0.7±2mm）相比，PS-TKA的俯卧位ATT显著更大（2±1.9mm）。
即使在如俯卧位这样对应日常活动的体位下，与BCS-TKA相比，PS-TKA的ATT也显著更大。
