Intraoperative mobile-bearing movement in Oxford unicompartmental knee arthroplasty
Intraoperative mobile-bearing movement in Oxford unicompartmental knee arthroplasty
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DOI：
10.1007/s00167-018-5064-6
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发表时间：
2019-07-01
影响因子：
3.8
通讯作者：
Tanaka, Sakae
中科院分区：
文献类型：
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作者：
Kawaguchi, Kohei;Inui, Hiroshi;Tanaka, Sakae
目的活动平台Oxford单髁膝关节置换术已被广泛应用并取得了成功，但目前尚无关于术中平台移动的研究。本研究的目的是观察术中关节面移动情况，并探讨关节面移动是否与假体位置、关节面尺寸、术中旋转运动学和临床结果有关。方法采用胫骨假体试模，每2 mm测量一次，测量移动的关节面的术中移动情况。从30 °屈曲到深屈曲的关节面运动分为两组：30例患者出现接触胫骨部件外侧壁的后关节面移动（W组），37例患者出现无接触或仅短暂接触的后关节面移动，结果所有移动的关节面在膝关节前后屈曲时均向后移动。在术后膝关节屈曲X线片中，W组的股骨部件明显比S组更外侧植入。W组胫骨平台与胫骨部件之间的宽度比显著大于S组。结论在膝关节屈曲过程中，所有移动的关节面均向后移动，而股骨部件置于外侧的移动的关节面在与外侧壁接触时，倾向于向后移动。然而，在临床评价中没有显著差异。
Purpose Mobile-bearing Oxford unicompartmental knee arthroplasty has been used widely and successfully; however, there is no previous research on the intraoperative bearing movement. The purpose of this study was to characterise intraoperative bearing movement and investigate whether bearing movement relates to component positions, bearing size, intraoperative rotational kinematics and clinical results.Methods A trial tibial component, which was scaled every 2 mm, was used to measure the intraoperative movement of the mobile bearings. Bearing movements from 30 degrees flexion to deep flexion were classified into two groups: 30 patients exhibited posterior bearing movement that contacted the lateral wall of the tibial component (Group W), and 37 patients exhibited posterior bearing movement, without contact, or with only transient contact, with the lateral wall (Group S).Results All mobile bearings moved posteriorly during knee flexion in the anteroposterior direction. In postoperative radiography with the knee flexed, the femoral component in Group W was significantly more laterally implanted than that in Group S. The width ratio between the bearing and tibial component in Group W was significantly greater than in Group S. There were no significant differences in other radiological measurements, intraoperative rotational kinematics or clinical results.Conclusion During knee flexion, all mobile bearings moved posteriorly, and mobile bearings whose femoral components were set laterally, tended to move posteriorly while in contact with the lateral wall. However, there were no significant differences in clinical evaluation.