An Intraoperative Pressure-Measuring Device Used in Total Knee Arthroplasties and Its Kinematics Correlations
An Intraoperative Pressure-Measuring Device Used in Total Knee Arthroplasties and Its Kinematics Correlations
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全膝关节置换术术中压力测量装置及其运动学关系
DOI：
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发表时间：
2004
影响因子：
4.2
通讯作者：
R. Komistek
中科院分区：
文献类型：
--
作者：
R. Wasielewski;D. Galat;R. Komistek
膝关节植入物的X线透视和取出分析显示，即使对于相同的植入物设计，也存在相当大的差异，并暗示了手术技术和间室压力平衡在全膝关节置换术中的可能重要性。本研究旨在将术中计算机评估的室压测量值与术后运动学相关联，以解释这些变化。38名患者采用平衡间隙技术进行后交叉韧带牺牲低接触应力全膝关节置换术。在试模复位时，将用于记录内侧和外侧间室压力大小、位置和动态印记的内固定胫骨垫片置入膝关节。以电子方式记录0°-120°运动范围内的压力。38名患者中有16名同意在透视监视下连续进行负重深膝弯曲。16例患者中只有3例发生髁突抬离，但均在单一屈曲角度下发生抬离。在3例髁突抬离的患者中，术中压力传感器测量的间室压力不平衡发生在相同的抬离屈曲角度。这些数据表明，尽管给定的植入物设计可能具有固有的运动学趋势，但手术技术和腔室压力平衡会显著影响运动学性能。
Fluoroscopic and retrieval analyses of knee implants show considerable variability even for the same implant design, and implicate the possible importance of surgical technique and compartment pressure balance in total knee arthroplasties. This study was done to correlate intraoperative computer-assessed compartment pressure measurements with postoperative kinematics to explain these variations. Thirty-eight patients had posterior cruciate-sacrificing low-contact stress total knee arthroplasties using a balanced gap technique. At trial reduction, an instrumented tibial insert designed to record the magnitude, location, and dynamic imprint of the pressures in the medial and lateral compartments was placed into the knee. Pressures were recorded electronically for a range of motion from 0°–120°. Sixteen of the 38 patients agreed to do successive weightbearing deep knee bends under fluoroscopic surveillance. Only three of the 16 patients had condylar lift-off, but all experienced lift-off at a single flexion angle. In the three patients who had condylar lift-off, a compartment pressure imbalance, as measured by the intraoperative pressure sensor, occurred at the same flexion angle of lift-off. These data suggest that although a given implant design may have inherent kinematic tendencies, surgical technique and compartment pressure balance significantly impact kinematic performance.