Posterior capsular release is a biomechanically safe procedure to perform in total knee arthroplasty
Posterior capsular release is a biomechanically safe procedure to perform in total knee arthroplasty
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DOI：
10.1007/s00167-018-5094-0
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发表时间：
2019-05-01
影响因子：
3.8
通讯作者：
Amis, Andrew A.
中科院分区：
文献类型：
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作者：
Athwal, K. K.;Milner, P. E.;Amis, Andrew A.
目的外科医生可能会尝试将后囊从股骨附着处剥离，以克服全膝关节置换术（TKA）中的屈曲挛缩；然而，尚不清楚这是否会影响植入膝关节的前后（AP）松弛度。本研究的目的是探讨 TKA 中后囊松解对 AP 松弛的影响，并将其与后交叉韧带 (PCL) 的约束进行比较。方法将八个尸体膝关节安装在六自由度测试装置中，并在 150N AP 力、有或没有 710N 轴向压缩载荷的情况下，在 0 度、30 度、60 度和 90 度屈曲下进行测试。对原生膝关节进行测试后，植入深凹型十字形固位全膝关节置换术并重复测试。然后切割 PCL，然后使用弯曲骨刀释放后囊。结果在施加 0N 轴向载荷时，切割 PCL 以及释放后囊，与所有屈曲角度下的原生膝相比，显着增加了后松弛度，并且 CR TKA 状态为 30 度、60 度和 90 度（p
PurposeSurgeons may attempt to strip the posterior capsule from its femoral attachment to overcome flexion contracture in total knee arthroplasty (TKA); however, it is unclear if this impacts anterior-posterior (AP) laxity of the implanted knee. The aim of the study was to investigate the effect of posterior capsular release on AP laxity in TKA, and compare this to the restraint from the posterior cruciate ligament (PCL).MethodsEight cadaveric knees were mounted in a six degree of freedom testing rig and tested at 0 degrees, 30 degrees, 60 degrees and 90 degrees flexion with 150N AP force, with and without a 710N axial compressive load. After the native knee was tested, a deep dished cruciate-retaining TKA was implanted and the tests were repeated. The PCL was then cut, followed by releasing the posterior capsule using a curved osteotome.ResultsWith 0N axial load applied, cutting the PCL as well as releasing the posterior capsule significantly increased posterior laxity compared to the native knee at all flexion angles, and CR TKA states at 30 degrees, 60 degrees and 90 degrees (p