Kinematic alignment is bone and soft tissue preserving compared to mechanical alignment in total knee arthroplasty
Kinematic alignment is bone and soft tissue preserving compared to mechanical alignment in total knee arthroplasty
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DOI：
10.1016/j.knee.2019.01.002
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发表时间：
2019-03-01
期刊：
影响因子：
1.9
通讯作者：
Fritsch, Brett A.
中科院分区：
文献类型：
--
作者：
An, Vincent V. G.;Twiggs, Joshua;Fritsch, Brett A.
背景资料：运动学对线（KA）全膝关节置换术（TKA）已成为机械对线（MA）TKA术中对线目标的替代方法。虽然已经研究了这两种理念的临床结局，但需要进一步研究，以准确量化这两种理念在矫正骨关节炎膝关节畸形（如固定屈曲畸形（FFD）和冠状面对线不良）的方法方面的差异。本文的目的是比较MA和KA的理念在TKA的FFD和冠状面对线不良的术中矫正和量化的方式，每个哲学实现了一个良好的平衡膝关节，可以达到完全extension.Methods：从210个连续的TKA收集的前瞻性数据进行回顾性分析，由一个单一的外科医生在2015年3月和2017年5月之间进行了。MA和KA的情况下进行了比较，在术前患者畸形和特点，术中采取的步骤，以纠正FFD（包括骨切除，软组织释放和组件使用）和术后对齐achieved.Results：一百二十MA和90 KA TKA进行了分析。两个队列之间的患者年龄、性别和术前冠状和矢状畸形无显著差异。KA TKA能够实现与MA TKA相同程度的矢状面矫正，全骨切除较少（16.7 mm vs. 18.9 mm，p < 0.0001），软组织释放较少（10% vs. 49.2%，p < 0.0001）。这是通过组件对齐的差异实现的。股骨更外翻（-2.5 vs. -0.03 °，p
Background: Kinematically aligned (KA) total knee arthroplasty (TKA) has emerged as an alternative approach to the intraoperative alignment targets of mechanically aligned (MA) TKA. While the clinical outcomes of the two philosophies have been investigated, further investigation is required to quantify exactly how the two philosophies differ in their approach to correcting the deformities encountered in osteoarthritic knees such as fixed flexion deformities (FFD) and corona] malalignment. The aim of this paper was to compare MA and KA philosophies in TKA in terms of the intra-operative correction of FFD and coronal malalignment and quantify the way in which each philosophy achieves a well-balanced knee that can reach full extension.Methods: A retrospective review of prospective data collected from 210 consecutive TKAs performed by a single surgeon between March 2015 and May 2017 was undertaken. MA and KA cases were compared in terms of pre-operative patient deformity and characteristics, intraoperative steps taken to correct FFD (including bony resections, soft tissue releases and components used) and postoperative alignment achieved.Results: One hundred twenty MA and 90 KA TKAs were analysed. There was no significant difference in terms of patient age, gender and preoperative coronal and sagittal deformity between the two cohorts. KA TKAs were able to achieve the same degree of sagittal correction as MA TKAs with less total bony resection (16.7 mm vs. 18.9 mm, p < 0.0001), less soft tissue releases (10% vs. 49.2%, p < 0.0001). This was achieved with a difference in component alignment. The femur was in more valgus (-2.5 vs. -0.03 degrees, p