Tone Shine, Naito Yohei, Wakabayashi Hiroki, Sudo Akihiro, Hasegawa Masahiro
Department of Orthopaedic Surgery, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, 514-8507, Mie, Japan.
BMC Musculoskelet Disord. 2025 Mar 13;26(1):251. doi: 10.1186/s12891-025-08478-2.
Bi-cruciate retaining (BCR) total knee arthroplasty (TKA) is considered to provide improved clinical function and kinematics compared with conventional TKA, but it is unclear which factors affect clinical outcomes after BCR TKA. This study aimed to investigate whether rotational alignment of the femoral and tibial components and rotational mismatch between the femoral and tibial components affected early clinical outcomes after BCR TKA, according to the 2011 version of the Knee Society Score (2011KSS).
This retrospective cohort study included 39 knees that underwent BCR TKA. Rotational alignment of the femoral and tibial components and rotational mismatch between the components were measured by computed tomography based three-dimensional evaluation software. 2011KSS was obtained at 3, 6, and 12 months postoperatively. The relationship of each of rotational alignment and rotational mismatch with 2011KSS was analyzed.
Rotational alignment of the femoral and tibial components was not correlated with symptoms, patient satisfaction, patient expectations, or functional activities at 3, 6, or 12 months postoperatively. Rotational mismatch was negatively correlated with symptoms, patient satisfaction and functional activities at 3 months; negatively correlated with symptoms and functional activities at 6 months; and negatively correlated with symptoms, patient satisfaction, patient expectations and functional activities at 12 months postoperatively.
Rotational mismatch between the femoral and tibial components was negatively correlated with 2011KSS, whereas no relationship of rotational alignment of the femoral and tibial components with 2011KSS was observed. Excessive external rotation of the tibial component relative to the femoral component resulted in worse early clinical outcomes.
与传统全膝关节置换术（TKA）相比，双交叉韧带保留（BCR）全膝关节置换术被认为能提供更好的临床功能和运动学表现，但目前尚不清楚哪些因素会影响BCR TKA术后的临床结果。本研究旨在根据2011版膝关节协会评分（2011KSS），探讨股骨和胫骨假体的旋转对线以及股骨和胫骨假体之间的旋转不匹配是否会影响BCR TKA术后的早期临床结果。
这项回顾性队列研究纳入了39例行BCR TKA的膝关节。通过基于计算机断层扫描的三维评估软件测量股骨和胫骨假体的旋转对线以及假体之间的旋转不匹配。在术后3个月、6个月和12个月时获取2011KSS评分。分析旋转对线和旋转不匹配与2011KSS评分之间的关系。
股骨和胫骨假体的旋转对线与术后3个月、6个月或12个月时的症状、患者满意度、患者期望或功能活动均无相关性。旋转不匹配在术后3个月时与症状、患者满意度和功能活动呈负相关；在术后6个月时与症状和功能活动呈负相关；在术后12个月时与症状、患者满意度、患者期望和功能活动呈负相关。
股骨和胫骨假体之间的旋转不匹配与2011KSS评分呈负相关，而未观察到股骨和胫骨假体的旋转对线与2011KSS评分之间存在关联。胫骨假体相对于股骨假体过度外旋会导致更差的早期临床结果。
