Razick Daniel, Akhtar Muzammil, Howell Stephen M, Nedopil Alexander J, Hull Maury L
College of Medicine California Northstate University Elk Grove California USA.
Department of Biomedical Engineering University of California Davis California USA.
J Exp Orthop. 2024 Nov 13;11(4):e70075. doi: 10.1002/jeo2.70075. eCollection 2024 Oct.
A previous study on osteoarthritic knees found that the average position of the centre of the proximal quadriceps tendon (PQT) was 9 mm lateral from the native trochlear groove. In patients with lateral patellar facet osteoarthritis, which indicates patellofemoral instability, the average location was 21 mm. The researchers suggested that a position more lateral than 20 mm might lead to poor outcomes after kinematically aligned total knee arthroplasty (KA TKA)-the current study aimed to test this hypothesis.
The study involved all patients ( = 302) who underwent KA TKA ( = 313) in 2019, had a post-operative long-leg scanogram and knee computed tomography scan, and completed a 2-year questionnaire. An evaluator measured the location of the PQT relative to the centre of the distal prosthetic trochlear groove. A Spearman's rank correlation coefficient analysis determined whether there was an association between the location of the PQT and the Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) at 2 years.
The mean location of the PQT was 11 ± 8 mm (range, -2 medial to 36 mm lateral), with 16% ( = 46) of the KA TKAs having a more lateral location than 20 mm. The location of the PQT was not associated with the FJS ( = -0.0349, = 0.7281) and OKS ( = -0.0641, = 0.9009)-no patient response indicated symptoms or operative treatment for patellofemoral instability.
Even though 16% of patients with a KA TKA had a more lateral location than 20 mm, there is no reason to measure the centre of the PQT relative to the distal prosthetic groove. This is because the location did not show any association with the 2-year FJS and OKS nor had any patient experienced patellofemoral instability.
IV.
先前一项针对骨关节炎膝关节的研究发现，股四头肌近端肌腱（PQT）中心的平均位置在距原生滑车沟外侧9毫米处。在外侧髌面骨关节炎患者中，这表明髌股关节不稳定，平均位置为21毫米。研究人员认为，在运动学对齐的全膝关节置换术（KA TKA）后，位置比20毫米更偏外侧可能会导致不良结果——本研究旨在验证这一假设。
该研究纳入了2019年接受KA TKA（n = 313）的所有患者（n = 302），这些患者术后进行了长腿扫描图和膝关节计算机断层扫描，并完成了一份为期2年的问卷。一名评估人员测量了PQT相对于远端假体滑车沟中心的位置。Spearman等级相关系数分析确定了PQT位置与2年时的遗忘关节评分（FJS）和牛津膝关节评分（OKS）之间是否存在关联。
PQT的平均位置为11±8毫米（范围为内侧-2毫米至外侧36毫米），16%（n = 46）的KA TKA位置比20毫米更偏外侧。PQT的位置与FJS（r = -0.0349，P = 0.7281）和OKS（r = -0.0641，P = 0.9009）均无关联——没有患者的反应表明存在髌股关节不稳定的症状或接受过手术治疗。
尽管16%的KA TKA患者的位置比20毫米更偏外侧，但没有理由测量PQT相对于远端假体沟的中心位置。这是因为该位置与2年时的FJS和OKS均无关联，也没有患者经历过髌股关节不稳定。
IV级。
