Stiehl J B, Dennis D A, Komistek R D, Keblish P A
Midwest Orthopaedic Biomechanical Laboratory, St. Luke's Medical Center, Milwaukee, WI, USA.
Clin Orthop Relat Res. 1997 Dec(345):60-6.
Ten normal subjects and 10 patients with a posterior cruciate retaining mobile bearing total knee replacement performed successive deep knee bends under fluoroscopy to determine tibiofemoral contact positions. At full extension the average initial contact position for the normal and mobile total knee replacement was 6.2 mm (range, 4.8 to 12 mm) anterior, and -4.4 mm (range, 3.9 to 11 mm) posterior to the sagittal tibial midplane, respectively. At 60 degrees flexion, the normal knee rolled back to -5.8 mm (range, -2.5 to -13.2 mm), whereas the mobile bearing total knee replacement rolled back to -9.2 mm (range, -4 to -17 mm). From 60 degrees to 90 degrees, normal knees rolled back to -7.8 mm (range, -5.8 to -13.8 mm), but the mobile bearing total knee replacement slid anteriorly to -5 mm (range, 2 to -12 mm). All mobile bearing total knee replacements had some form of roll back, but some slid anterior more than others. Five of 10 mobile bearing total knee replacements had some movement of the bearings while the others remained fixed. Patellar kinematics was similar to normal but reflected tibiofemoral abnormalities.
10名正常受试者和10名接受后交叉韧带保留型活动平台全膝关节置换术的患者在透视引导下进行连续的深屈膝动作，以确定胫股关节的接触位置。在完全伸直时，正常膝关节和活动平台全膝关节置换术的平均初始接触位置分别位于胫骨矢状面中点前方6.2毫米（范围为4.8至12毫米）和后方-4.4毫米（范围为3.9至11毫米）。在屈膝60度时，正常膝关节向后滚动至-5.8毫米（范围为-2.5至-13.2毫米），而活动平台全膝关节置换术向后滚动至-9.2毫米（范围为-4至-17毫米）。从60度到90度，正常膝关节向后滚动至-7.8毫米（范围为-5.8至-13.8毫米），但活动平台全膝关节置换术向前滑动至-5毫米（范围为2至-12毫米）。所有活动平台全膝关节置换术都有某种形式的向后滚动，但有些向前滑动的程度比其他的更大。10个活动平台全膝关节置换术中，有5个的活动平台有一些移动，而其他的则保持固定。髌股运动学与正常情况相似，但反映了胫股关节的异常。
