Comparison of Tibial Tubercle Landmark Technique and Range of Motion Technique in Primary Total Knee Arthroplasty: A Retrospective Cohort Study.
Comparison of Tibial Tubercle Landmark Technique and Range of Motion Technique in Primary Total Knee Arthroplasty: A Retrospective Cohort Study.
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DOI：
10.1111/os.13486
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发表时间：
2022-12
影响因子：
2.1
通讯作者：
Xiang Chuan
中科院分区：
文献类型：
--
作者：
Liu Xin;Mao Xingjia;Guo Shengjie;Cao Yanwei;Li Shuaijie;Xiang Chuan
全膝关节置换术（TKA）中胫骨部件的旋转对线没有标准。目前，最常用的方法是胫骨结节标志技术（TTL）和活动范围技术（ROM）。本研究旨在比较采用TTL或ROM技术进行初次TKA的患者的临床结局和影像学数据。这项单外科医生回顾性队列研究包括2017年12月至2019年1月期间采用TTL技术的60例患者和采用ROM技术的60例患者。所有患者均在术前和术后6个月和12个月进行临床评估，包括特殊外科医院膝关节评分（HSS）、Feller髌骨评分、视觉模拟评分（VAS）和最大膝关节屈伸角。影像学数据包括术前和术后X线片上的髋-膝-踝角（HKA）、股骨远端外侧机械角（mLDFA）、胫骨近端内侧机械角（mMPTA）、后倾角（PSA）和股骨部件旋转角（相对于手术经上髁轴）和胫骨部件（相对于手术经上髁轴、胫骨后髁线和Akagi）。比较两组的临床结局和影像学资料。120例患者（120膝）入组本研究，其中男性38例，女性82例，年龄58 ~ 78岁，平均65.7岁。两组患者的人口统计学资料和术前X线资料差异无统计学意义（P > 0. 05）。05）。术后6个月和12个月时，TTL组的临床评分优于ROM组，（83.57 ± 5.00 vs 75.90 ± 4.89，F = 59.004，P < 0.001; 90.53 ± 4.31vs82.83 ± 4.98，F = 54.509，P < 0.001），Feller髌骨评分（21.43 ± 2.54 vs 19.10 ± 2.52，F = 14.864，P = 0.001; 26.27 ± 1.98 vs23.20 ± 2.31，F = 42.204，P < 0.001）和VAS（3.70 ± 0.62 vs 4.38 ± 0.92，F = 14.508，P = 0.001; 2.10 ± 0.90 vs 2.79 ± 0.80，F = 11.554，P = 0.002）。但两组患者的前屈和后伸角度差异无显著性。在影像学评价中，未发现术前和术后HKA、mLDFA、mMPTA和PSA存在统计学差异。两组仅胫骨假体相对于Akagi假体的旋转角度有统计学差异（2.33 ± 4.3vs4.41 ± 3.2，t = 2.143，P < 0.05）（正值代表外旋）。结果表明，两种方法均可靠，TTL技术比ROM技术提供更好的临床评分和更大的胫骨组件外角。术后CT扫描显示组件轴和三条参考线。
There is not a standard for rotational alignment of the tibial component in total knee arthroplasty (TKA). For now, the most commonly methods are tibial‐tubercle ‐landmark technique (TTL) and range‐of‐motion technique (ROM). The study is aimed to compare clinical outcomes and radiographic data of patients who undergone primary TKA with TTL or ROM technique. This single‐surgeon retrospective cohort study includes 60 patients with TTL technique and 60 with ROM technique from December 2017 to January 2019. All patients were evaluated clinically using Hospital for Special Surgery Knee Score (HSS), Feller patellar score, visual analogue scale (VAS) and maximum knee flexion and extension angle before and after surgery at both 6 months and 12 months postoperatively. Radiographic data contain hip‐knee‐ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), posterior slope angle (PSA) on pre and postoperative X‐ray and rotation angle of femoral component (relative to surgical trans‐epicondylar axis) and tibial component (relative to surgical trans‐epicondylar axis, tibial posterior condylar line and Akagi’) on postoperative computed tomography (CT) scan. Clinical outcomes and radiological data were compared between the two groups. One hundred twenty patients (120 knees) were enrolled in this study, including 38 males and 82 females, aged from 58 to 78, with an average of 65.7 years. There was no significant difference in demographics and preoperative X‐ray data between the two groups (P > 0. 05). Clinical scores of the TTL group were better than those in the ROM group at 6 and 12 months after surgery, when comparing HSS (83.57 ± 5.00 vs 75.90 ± 4.89, F = 59.004, P < 0.001; 90.53 ± 4.31 vs 82.83 ± 4.98, F = 54.509, P < 0.001), Feller patellar score (21.43 ± 2.54 vs 19.10 ± 2.52, F = 14.864, P = 0.001; 26.27 ± 1.98 vs 23.20 ± 2.31, F = 42.204, P < 0.001) and VAS (3.70 ± 0.62 vs 4.38 ± 0.92, F = 14.508, P = 0.001; 2.10 ± 0.90 vs 2.79 ± 0.80, F = 11.554, P = 0.002). But there was no significant difference in the flexion and extension angle between the two groups. In imaging evaluation, no statistical difference was found in pre‐ and postoperative HKA, mLDFA, mMPTA and PSA. Rotational angles of tibial component only did relative to Akagi’ have statistical difference in two groups (2.33 ± 4.3 vs 4.41 ± 3.2, t = 2.143, P < 0.05) (Positive value represented external rotation). The results of our study showed that both methods were reliable, and TTL technique provided better clinical scores and larger external angle of tibial component, compared to ROM technique. Postoperative CT scans shows component axis and three reference lines.
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DOI：
10.1302/0301-620x.91b5.21827
发表时间：
2009-05-01
影响因子：
--
作者：
Victor, J.;Van Doninck, D.;Bellemans, J.
通讯作者：
Bellemans, J.
影响因子：
3.5
作者：
Lawrie, Charles M.;Noble, Philip C.;Incavo, Steve J.
通讯作者：
Incavo, Steve J.
影响因子：
1.8
作者：
Yin, Li;Chen, Kaining;Yang, Liu
通讯作者：
Yang, Liu
影响因子：
3.8
作者：
Seo, Jai-Gon;Moon, Young-Wan;Kim, Sang-Min
通讯作者：
Kim, Sang-Min
影响因子：
3.8
作者：
Talbot, Simon;Dimitriou, Pandelis;Bartlett, John
通讯作者：
Bartlett, John