Abstract：
BACKGROUND: Anterior knee pain (AKP) is one of the reasons for dissatisfaction after total knee replacement (TKR). It may result from patellofemoral joint dysfunction, caused by improper rotation of implant components. The aim of this study was to analyze patella positioning in patients after standard measured resection TKR and TKR with a use of a dynamic tensioner, and to assess the frequency of AKP, range of motion (ROM), and patient-reported outcome measures 6 weeks and 3 months postoperatively.
METHODS: The study consisted of 127 patients who underwent TKR. Eighty-nine of them treated with use of the dynamic tensioner FUZION formed the study group; the remainder formed the control group. All participants received cemented PERSONA MC without patella resurfacing. All patients had a standard anteroposterior, lateral weight-bearing, long-leg view X-ray and computed tomography examination in 30° of knee flexion following the procedure.
RESULTS: There were no significant differences between the study and the control groups regarding: posterior condylar axis (PCA)-patella angle, surgical transepicondylar axis (sTEA)-patella angle, PCA-sTEA angle, deviation from 90° in PCA-patella, sTEA-patella and PCA-sTEA angles. No significant difference was found in a ratio of obtaining PCA-patella angle deviation of more than 3°. Regarding clinical parameters, statistically and questionablly clinically significant difference in favor of the Study Group was found in Forgotten Joint Score 6 weeks and 3 months post-operativley and ROM 6 weeks post-operatively. However, such difference was not found by analyzing ROM 3 months post-operatively, AKP and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.
CONCLUSIONS: Compared with the standard 3° of femoral component external rotation, use of a dynamic tensioner does not allow for more accurate restoration of the patellar facet position with reference to the PCA.
METHODS: The study consisted of 127 patients who underwent TKR. Eighty-nine of them treated with use of the dynamic tensioner FUZION formed the study group; the remainder formed the control group. All participants received cemented PERSONA MC without patella resurfacing. All patients had a standard anteroposterior, lateral weight-bearing, long-leg view X-ray and computed tomography examination in 30° of knee flexion following the procedure.
RESULTS: There were no significant differences between the study and the control groups regarding: posterior condylar axis (PCA)-patella angle, surgical transepicondylar axis (sTEA)-patella angle, PCA-sTEA angle, deviation from 90° in PCA-patella, sTEA-patella and PCA-sTEA angles. No significant difference was found in a ratio of obtaining PCA-patella angle deviation of more than 3°. Regarding clinical parameters, statistically and questionablly clinically significant difference in favor of the Study Group was found in Forgotten Joint Score 6 weeks and 3 months post-operativley and ROM 6 weeks post-operatively. However, such difference was not found by analyzing ROM 3 months post-operatively, AKP and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.
CONCLUSIONS: Compared with the standard 3° of femoral component external rotation, use of a dynamic tensioner does not allow for more accurate restoration of the patellar facet position with reference to the PCA.
摘要：
背景：膝关节前疼痛（AKP）是全膝关节置换术（TKR）后不满意的原因之一。可能是由于髌股关节功能障碍,由植入物组件的不当旋转引起的。这项研究的目的是分析标准测量切除TKR和TKR后使用动态张紧器的患者的髌骨定位，为了评估AKP的频率，运动范围（ROM），以及术后6周和3个月患者报告的结局指标。
方法：该研究包括127例接受TKR的患者。其中89例使用动态张紧器FUZION进行治疗，形成了研究组；其余的形成了对照组。所有参与者均接受水泥PERSONAMC，未进行髌骨重铺。所有患者都有标准的前后，侧向承重,手术后膝关节屈曲30°的长腿X射线和计算机断层扫描检查。
结果：研究与对照组之间在以下方面没有显着差异：后髁轴（PCA）-髌骨角，手术经髁轴（sTEA）-髌骨角，PCA-sTEA角度,PCA-髌骨偏离90°，sTEA-髌骨和PCA-sTEA角度。获得PCA-髌骨角偏差大于3°的比率没有发现显着差异。关于临床参数，在术后6周和3个月的遗忘关节评分和术后6周的ROM中发现了有利于研究组的统计学和可疑的临床显着差异。然而,通过分析术后3个月的ROM没有发现这种差异，AKP和西安大略省和麦克马斯特大学骨关节炎指数（WOMAC）得分。
结论：与标准3°股骨构件外旋相比，动态张紧器的使用不允许相对于PCA更准确地恢复髌骨小面位置。
方法：该研究包括127例接受TKR的患者。其中89例使用动态张紧器FUZION进行治疗，形成了研究组；其余的形成了对照组。所有参与者均接受水泥PERSONAMC，未进行髌骨重铺。所有患者都有标准的前后，侧向承重,手术后膝关节屈曲30°的长腿X射线和计算机断层扫描检查。
结果：研究与对照组之间在以下方面没有显着差异：后髁轴（PCA）-髌骨角，手术经髁轴（sTEA）-髌骨角，PCA-sTEA角度,PCA-髌骨偏离90°，sTEA-髌骨和PCA-sTEA角度。获得PCA-髌骨角偏差大于3°的比率没有发现显着差异。关于临床参数，在术后6周和3个月的遗忘关节评分和术后6周的ROM中发现了有利于研究组的统计学和可疑的临床显着差异。然而,通过分析术后3个月的ROM没有发现这种差异，AKP和西安大略省和麦克马斯特大学骨关节炎指数（WOMAC）得分。
结论：与标准3°股骨构件外旋相比，动态张紧器的使用不允许相对于PCA更准确地恢复髌骨小面位置。
