一种用于全膝关节置换术中实现软组织平衡的新型网格辅助压饼技术。
A novel grid-assisted pie-crusting technique for achieving soft tissue balance in total knee arthroplasty.
作者信息
Cheng Qisheng, Wang Yang, Liu Yi, Mu Jie, Wang Zhenyan, Lin Xu, Yin Guanchen, Li Shuqiang
机构信息
Department of Orthopedic Center, The First Hospital of Jilin University, Changchun, China.
The First Operation Room, The First Hospital of Jilin University, Changchun, China.
出版信息
Front Surg. 2025 Mar 18;12:1566642. doi: 10.3389/fsurg.2025.1566642. eCollection 2025.
BACKGROUND
To evaluate the effectiveness of a novel grid-based pie-crusting technique for soft tissue release at different locations of the medial collateral ligament (MCL) during total knee arthroplasty (TKA).
METHODS
Twelve fresh-frozen cadaveric knee joints were dissected. A novel grid was designed to cover the entire surface of the MCL. The specimens were divided into two groups: Group A, where only the central portion of the ligament underwent pie-crusting release, and Group B, where selective release targeted the femoral and tibial attachment points of the MCL. Mechanical testing was conducted via a Shimadzu AG-X precision instrument. Each group underwent twelve punctures, and data were collected to calculate deformation and stiffness metrics. The mean elongation and stiffness values were analyzed, and regression analysis was performed to evaluate correlations between the number of punctures and changes in elongation and stiffness.
RESULTS
No significant differences in initial stiffness were observed between the two groups ( = 0.42). Following 12 punctures, the stiffness decreased by 6.47 ± 4.06 N/mm in Group A and 1.08 ± 1.32 N/mm in Group B ( = 0.006). Despite this disparity in stiffness reduction, no significant differences in MCL elongation were observed between the groups. Group A demonstrated an elongation of 0.171 ± 0.180 mm, whereas Group B exhibited an elongation of 0.164 ± 0.123 mm ( = 0.47). A linear relationship was identified between stiffness reduction and the number of punctures ( = 0.61 ± 0.29), as well as between ligament elongation and the number of punctures ( = 0.89 ± 0.09).
CONCLUSION
The grid-assisted pie-crusting technique, which uniformly covers the MCL, enables precise and controlled soft tissue release. This approach provides valuable insights for clinicians performing MCL release during TKA, facilitating improved soft tissue balance and potentially enhancing surgical outcomes.
背景
评估一种新型基于网格的“馅饼皮”技术在全膝关节置换术（TKA）期间用于内侧副韧带（MCL）不同部位软组织松解的有效性。
方法
解剖12个新鲜冷冻的尸体膝关节。设计了一种新型网格以覆盖MCL的整个表面。标本分为两组：A组，仅韧带中央部分进行“馅饼皮”松解；B组，选择性松解针对MCL的股骨和胫骨附着点。通过岛津AG-X精密仪器进行力学测试。每组进行12次穿刺，并收集数据以计算变形和刚度指标。分析平均伸长率和刚度值，并进行回归分析以评估穿刺次数与伸长率和刚度变化之间的相关性。
结果
两组之间初始刚度无显著差异（P = 0.42）。12次穿刺后，A组刚度降低6.47±4.06 N/mm，B组降低1.08±1.32 N/mm（P = 0.006）。尽管刚度降低存在差异，但两组之间MCL伸长率无显著差异。A组伸长率为0.171±0.180 mm，而B组伸长率为0.164±0.123 mm（P = 0.47）。确定了刚度降低与穿刺次数之间的线性关系（r = 0.61±0.29），以及韧带伸长率与穿刺次数之间的线性关系（r = 0.89±0.09）。
结论
均匀覆盖MCL的网格辅助“馅饼皮”技术能够实现精确且可控的软组织松解。该方法为在TKA期间进行MCL松解的临床医生提供了有价值的见解，有助于改善软组织平衡并可能提高手术效果。
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