Elkabbani Mohamed, Saied Ahmed Mostafa, Abouelnas Bassam Ali, Dragos Apostu, Osman Amr, Tarabichi Samih
Department of Orthopaedic Surgery, Faculty of Medicine, Mansoura University, Dakahlia Governorate, 25. El Gomhouria St, Mansoura, 35516, Egypt.
Department of Orthopaedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
BMC Musculoskelet Disord. 2024 Dec 12;25(1):1009. doi: 10.1186/s12891-024-07975-0.
Malrotation of the tibial components in total knee arthroplasties is a common cause of pain and functional impairment. There are multiple methods used to establish the tibial component rotation, but there is still no consensus which method is the best.The objective of this study was to compare two of the most commonly used techniques, that is the use of self-alignment during passive range of motion (free-floating technique) versus the anterior cortex referencing method (Curve-on-curve technique).
Twenty-eight consecutive patients with advanced varus-type osteoarthritis scheduled for posterior stabilized total knee replacement with symmetrical tibial baseplate were included in the study. We set the location of the tibial component trial using the method of self-alignment during passive range of motion and compared it to the location of the tibial component trial when referenced to the anterior cortex. The distance between the two locations was independently measured by two experienced surgeons.
In all of the cases, the tibial component centre was located more laterally on the anterior tibial cortex in the anterior cortex referencing technique when compared to the self-alignment technique [range 3-19 mm].
The tibial components placed using the anterior referencing technique (Curve-on-curve technique) are more externally rotated as compared to those placed using the self-alignment technique (free-floating technique) in posterior stabilized total knee arthroplasties using symmetrical tibial components.
全膝关节置换术中胫骨组件旋转不良是疼痛和功能障碍的常见原因。有多种方法用于确定胫骨组件的旋转，但哪种方法最佳仍未达成共识。本研究的目的是比较两种最常用的技术，即在被动活动范围内使用自对准（自由浮动技术）与前皮质参考方法（曲线对曲线技术）。
本研究纳入了28例连续的晚期内翻型骨关节炎患者，计划行后稳定型全膝关节置换术并使用对称胫骨基板。我们使用被动活动范围内自对准方法设置胫骨组件试验的位置，并将其与参考前皮质时胫骨组件试验的位置进行比较。两位经验丰富的外科医生独立测量两个位置之间的距离。
在所有病例中，与自对准技术相比，前皮质参考技术中胫骨组件中心在前胫骨皮质上的位置更偏外侧[范围3 - 19毫米]。
在使用对称胫骨组件的后稳定型全膝关节置换术中，与使用自对准技术（自由浮动技术）放置的胫骨组件相比，使用前参考技术（曲线对曲线技术）放置的胫骨组件向外旋转更多。
