在单髁膝关节置换术中，在不改变胫骨近端内侧角的情况下，对胫骨后倾进行靶向调整是可行的。
Targeted adjustment of the posterior tibial slope in unicompartmental knee arthroplasty is feasible without altering the medial proximal tibial angle.
作者信息
El Kayali Moses K D, Berndt Rosa, Gwinner Clemens, Pichler Lorenz
机构信息
Center for Musculoskeletal Surgery Charité - Universitätsmedizin Berlin Berlin Germany.
Department of Orthopedics and Trauma-Surgery Medical University of Vienna Vienna Austria.
出版信息
J Exp Orthop. 2025 May 19;12(2):e70286. doi: 10.1002/jeo2.70286. eCollection 2025 Apr.
PURPOSE
Recommendations regarding the surgical modification of the medial posterior tibial slope (mPTS) in medial unicompartmental knee arthroplasty (UKA) vary. Given the high preoperative variability, this often results in a significant change in the patient's mPTS through UKA. However, it is unclear whether this change in mPTS impacts the coronal alignment, specifically the medial proximal tibial angle (MPTA). Therefore, the purpose of this study was to report on the preoperative to post-operative changes in mPTS and MPTA and their potential correlation in UKA.
METHODS
Pre- and post-operative radiographs of 96 consecutive patients undergoing conventional medial UKA were analyzed. Pre- and post-operative mPTS and MPTA were measured on radiographs by two observers and reported. Their differences, as well as the difference from the target value of 7°, were analyzed. Cases were grouped regarding their mPTS change into cases with <3° and cases with ≥3° mPTS change, and the correlation between changes in mPTS and changes in MPTA was reported.
RESULTS
The mean mPTS was reported at 9.27° (standard deviation [SD], 3.41°) preoperatively and 7.25° (SD, 2.23°) post-operatively, with a mean change of -2.02° (SD, 3.84°; < 0.001). Overall, 71.7% of cases had a post-operative mPTS within ±2° of 7° without significant difference from the target value of 7° ( = 0.797). At a mean preoperative MPTA of 85.39° (SD, 2.34°) and a mean post-operative MPTA of 84.12° (SD, 2.55°), UKA resulted in an average change of MPTA of -1.28° (SD, 2.55°; < 0.001). Correlation coefficients revealed very weak correlations between the change in mPTS and the change in MPTA for all groups ( < -0.13 in all).
CONCLUSIONS
Targeted mPTS modification can be achieved, which implies a significant change from preoperative mPTS values in patients undergoing UKA. However, the change in mPTS does not affect the change in MPTA.
LEVEL OF EVIDENCE
Level III.
目的
关于内侧单髁膝关节置换术（UKA）中胫骨后内侧坡度（mPTS）手术调整的建议各不相同。鉴于术前变异性高，这通常会导致患者通过UKA使mPTS发生显著变化。然而，尚不清楚mPTS的这种变化是否会影响冠状面排列，特别是胫骨近端内侧角（MPTA）。因此，本研究的目的是报告UKA中mPTS和MPTA从术前到术后的变化及其潜在相关性。
方法
分析了96例连续接受传统内侧UKA患者的术前和术后X线片。两名观察者在X线片上测量并报告术前和术后的mPTS和MPTA。分析了它们之间的差异，以及与7°目标值的差异。根据mPTS变化将病例分为mPTS变化<3°的病例和mPTS变化≥3°的病例，并报告mPTS变化与MPTA变化之间的相关性。
结果
术前平均mPTS报告为9.27°（标准差[SD]，3.41°），术后为7.25°（SD，2.23°），平均变化为-2.02°（SD，3.84°；P<0.001）。总体而言，71.7%的病例术后mPTS在距7°±2°范围内，与7°目标值无显著差异（P=0.797）。术前MPTA平均为85.39°（SD，2.34°），术后MPTA平均为84.12°（SD，2.55°），UKA导致MPTA平均变化-1.28°（SD，2.55°；P<0.001）。相关系数显示所有组中mPTS变化与MPTA变化之间的相关性非常弱（所有组中P<-0.13）。
结论
可以实现有针对性的mPTS调整，这意味着接受UKA的患者术前mPTS值有显著变化。然而，mPTS的变化并不影响MPTA的变化。
证据水平
三级。
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