In vivo function of posterior cruciate ligament before and after posterior cruciate ligament-retaining total knee arthroplasty
In vivo function of posterior cruciate ligament before and after posterior cruciate ligament-retaining total knee arthroplasty
复制标题
后交叉韧带保留全膝关节置换术前后后交叉韧带的体内功能
DOI：
10.1007/s00264-011-1481-6
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发表时间：
2012-07-01
影响因子：
2.7
通讯作者：
Li, Guoan
中科院分区：
文献类型：
--
作者：
Yue, Bing;Varadarajan, Kartik M.;Li, Guoan
目的本研究的目的是探讨保留PCL的全膝关节置换术(TKA)前后患者后交叉韧带(PCL)的体内功能。方法招募11名晚期膝骨关节炎(OA)患者。获得每个 OA 膝关节的磁共振扫描，并创建 3D 计算机模型，包括 PCL 前外侧和后内侧束的股骨和胫骨插入区域。在 PCL 保留 TKA 前后，在膝关节负重屈曲期间获取每个膝关节的双透视图像。图像和计算机模型用于重现膝盖的体内运动。 PCL 束的功能用伸长、升高和偏差来描述。还包括 22 名健康对照作为正常参考。结果与正常膝相比，OA 膝关节的 PCL 束在膝关节屈曲后期过度拉伸，并且在整个屈曲过程中定向更内侧。 PCL 保留 TKA 后，PCL 束在后期屈曲过程中进一步过度拉伸，并从正常膝关节和 OA 膝关节的内侧定向变为几乎矢状定向，这可能会损害控制膝关节旋转的功能。 结论 目前的 PCL 保留 TKA 系统和手术技术可能无法在 PCL 保留 TKA 后充分重建 PCL 束的正常生物力学。
PurposeThe object of this study was to investigate the in vivo function of the posterior cruciate ligament (PCL) in patients before and after a PCL-retaining total knee arthroplasty (TKA).MethodsEleven patients with advanced osteoarthritis (OA) of the knee were recruited. Magnetic resonance scans of each OA knee were obtained, and 3D computer models, including the femoral and tibial insertion areas of the anterolateral and posteromedial bundles of the PCL, were created. Before and after PCL-retaining TKA, dual fluoroscopic images of each knee were acquired during weight-bearing knee flexion. The images and computer models were used to reproduce the in vivo motion of the knee. The function of the PCL bundles was described in terms of elongation, elevation and deviation. Twenty-two healthy controls were also included as normal references.ResultsPCL bundles of the OA knees were overstretched during late knee flexion and orientated more medially throughout flexion compared with normal knees. After PCL-retaining TKA, PCL bundles were further overstretched during late flexion and changed from medially directed in normal and OA knees to almost sagittally directed, which may compromise function in controlling knee rotation.ConclusionsThe current PCL-retaining TKA systems and surgical techniques may not adequately re-establish normal biomechanics of PCL bundles after PCL-retaining TKA.