PDF(Pubmed)
Abstract：
UNASSIGNED: Proper soft-tissue balance was essential in total knee arthroplasty (TKA). Superficial medial collateral ligament (sMCL) release has been recommended in correction of severe varus knee. However, it has concerns of overcorrection. This study aimed to analyze coronal plane laxity in sMCL-released TKA patients.
UNASSIGNED: We prospectively collected data from TKA patients who were operated from January 2015 to November 2018. All patients went through the same surgical steps; however, sMCL was left intact in mild-to-moderate deformity (sMCL-intact), while it was completely released in patients with severe deformity (sMCL-released). All patients went through the same postoperative protocol. We used stress radiograph with 90 N force to evaluate coronal plane laxity and recorded modified Western Ontario and McMaster Universities Osteoarthritis Index score at 3- to 6-year postoperative appointments.
UNASSIGNED: There were 46 patients (59 knees) included with an average follow-up time of 48.3 months. The sMCL-intact group consisted of 14 patients (16 knees) with average preoperative mechanical axis (MA) varus of 4.84 degrees exhibited 1.64 mm (0.6-3.6 mm) laxity on medial side and 1.01 mm (0-3.1 mm) on lateral side. The sMCL-released group consisted of 32 patients (43 knees) with average preoperative MA varus of 14.74 degree exhibited 1.96 mm (0.4-4.8 mm) laxity on medial side and 1.57 mm (0.1-5.9 mm) on lateral side. At the time of follow-up, the mean modified Western Ontario and McMaster Universities Osteoarthritis Index in the sMCL-intact and sMCL-released groups were 14.8 and 13.5 (P value .79), respectively. There was no clinical laxity or reoperation of any causes in either groups.
UNASSIGNED: Complete release of sMCL in severe varus knee does not result in overcorrection after TKA at the midterm follow-up period. Thus, sMCL release technique could be an effective and safe option for correction of severe varus deformity.
UNASSIGNED: We prospectively collected data from TKA patients who were operated from January 2015 to November 2018. All patients went through the same surgical steps; however, sMCL was left intact in mild-to-moderate deformity (sMCL-intact), while it was completely released in patients with severe deformity (sMCL-released). All patients went through the same postoperative protocol. We used stress radiograph with 90 N force to evaluate coronal plane laxity and recorded modified Western Ontario and McMaster Universities Osteoarthritis Index score at 3- to 6-year postoperative appointments.
UNASSIGNED: There were 46 patients (59 knees) included with an average follow-up time of 48.3 months. The sMCL-intact group consisted of 14 patients (16 knees) with average preoperative mechanical axis (MA) varus of 4.84 degrees exhibited 1.64 mm (0.6-3.6 mm) laxity on medial side and 1.01 mm (0-3.1 mm) on lateral side. The sMCL-released group consisted of 32 patients (43 knees) with average preoperative MA varus of 14.74 degree exhibited 1.96 mm (0.4-4.8 mm) laxity on medial side and 1.57 mm (0.1-5.9 mm) on lateral side. At the time of follow-up, the mean modified Western Ontario and McMaster Universities Osteoarthritis Index in the sMCL-intact and sMCL-released groups were 14.8 and 13.5 (P value .79), respectively. There was no clinical laxity or reoperation of any causes in either groups.
UNASSIGNED: Complete release of sMCL in severe varus knee does not result in overcorrection after TKA at the midterm follow-up period. Thus, sMCL release technique could be an effective and safe option for correction of severe varus deformity.
摘要：
■在全膝关节置换术（TKA）中，适当的软组织平衡至关重要。建议在矫正严重的膝内翻时释放浅内侧副韧带（sMCL）。然而,它担心过度修正。本研究旨在分析sMCL释放的TKA患者的冠状平面松弛。
■我们前瞻性收集了2015年1月至2018年11月手术的TKA患者的数据。所有患者都经历了相同的手术步骤；然而，sMCL在轻度至中度畸形中保持完整（sMCL完整），而严重畸形患者完全释放（sMCL释放）。所有患者都经过相同的术后方案。我们使用90N力的应力X线片来评估冠状平面松弛度，并在术后3至6年预约时记录了改良的西安大略省和麦克马斯特大学骨关节炎指数评分。
■纳入46例患者（59膝），平均随访时间48.3个月。sMCL完整组包括14例患者（16膝），术前平均机械轴（MA）内翻4.84度，内侧松弛1.64mm（0.6-3.6mm），外侧松弛1.01mm（0-3.1mm）。sMCL释放组由32例患者（43膝）组成，术前平均MA内翻为14.74度，内侧松弛1.96mm（0.4-4.8mm），外侧松弛1.57mm（0.1-5.9mm）。在后续行动时，sMCL完整组和sMCL释放组的改良西安大略省和麦克马斯特大学骨关节炎指数均值分别为14.8和13.5(P值79),分别。两组均无临床松弛或任何原因的再次手术。
■严重膝内翻完全释放sMCL不会导致中期随访期间TKA后过度矫正。因此，sMCL释放技术可能是矫正严重内翻畸形的有效和安全的选择。
■我们前瞻性收集了2015年1月至2018年11月手术的TKA患者的数据。所有患者都经历了相同的手术步骤；然而，sMCL在轻度至中度畸形中保持完整（sMCL完整），而严重畸形患者完全释放（sMCL释放）。所有患者都经过相同的术后方案。我们使用90N力的应力X线片来评估冠状平面松弛度，并在术后3至6年预约时记录了改良的西安大略省和麦克马斯特大学骨关节炎指数评分。
■纳入46例患者（59膝），平均随访时间48.3个月。sMCL完整组包括14例患者（16膝），术前平均机械轴（MA）内翻4.84度，内侧松弛1.64mm（0.6-3.6mm），外侧松弛1.01mm（0-3.1mm）。sMCL释放组由32例患者（43膝）组成，术前平均MA内翻为14.74度，内侧松弛1.96mm（0.4-4.8mm），外侧松弛1.57mm（0.1-5.9mm）。在后续行动时，sMCL完整组和sMCL释放组的改良西安大略省和麦克马斯特大学骨关节炎指数均值分别为14.8和13.5(P值79),分别。两组均无临床松弛或任何原因的再次手术。
■严重膝内翻完全释放sMCL不会导致中期随访期间TKA后过度矫正。因此，sMCL释放技术可能是矫正严重内翻畸形的有效和安全的选择。
