PDF(Pubmed)
Abstract：
UNASSIGNED: Following total knee arthroplasty (TKA), normal knee kinematics are rarely replicated. Retention of both cruciate ligaments (bicruciate retaining TKA) has helped this. Postoperative posterior tibial slope (PPTS) may further affect ligament tension and kinematics. The objective of this study is to determine how changes between the preoperative posterior tibial slope (PTS) and PPTS affect knee kinematics.
UNASSIGNED: Twenty bicruciate retaining TKAs were performed using standard instrumentation. Fluoroscopic kinematic data were obtained during gait and a single knee bend. Differences (Δ) between radiographic measurements of preoperative and PPTS were correlated with in-vivo knee kinematics. Patients were separated into 2 groups based on their Δ values. Group I consisted of Δ values less than 0.7, indicating either a similar PPTS compared to preoperative PTS or a slightly flatter PPTS. Group II consisted of Δ values above 0.7, indicating a steepened PPTS.
UNASSIGNED: Preoperative PTS values ranged from -0.5° to 11.2°, with an average of 5.0° ± 3.4°. PPTS values ranged from 3.0° to 12.1°, with an average of 7.1° ± 3.1°. Weight-bearing range of motion (WBROM) measured from 94° to 139°, and femorotibial axial rotation ranged from -2.9° to 17.3°. A t-test revealed average values for WBROM in Group IT (Δ < 0.7) to be significantly greater than those for Group IIT (Δ > 0.7) (P = .01).
UNASSIGNED: These findings indicate that either a PPTS approximating the preoperative PTS or a slightly flattened PPTS in comparison (Δ < 0.7) is associated with WBROM greater than 130°. Values for axial rotation and anterior sliding were not significantly associated with changes to the PTS.
UNASSIGNED: Twenty bicruciate retaining TKAs were performed using standard instrumentation. Fluoroscopic kinematic data were obtained during gait and a single knee bend. Differences (Δ) between radiographic measurements of preoperative and PPTS were correlated with in-vivo knee kinematics. Patients were separated into 2 groups based on their Δ values. Group I consisted of Δ values less than 0.7, indicating either a similar PPTS compared to preoperative PTS or a slightly flatter PPTS. Group II consisted of Δ values above 0.7, indicating a steepened PPTS.
UNASSIGNED: Preoperative PTS values ranged from -0.5° to 11.2°, with an average of 5.0° ± 3.4°. PPTS values ranged from 3.0° to 12.1°, with an average of 7.1° ± 3.1°. Weight-bearing range of motion (WBROM) measured from 94° to 139°, and femorotibial axial rotation ranged from -2.9° to 17.3°. A t-test revealed average values for WBROM in Group IT (Δ < 0.7) to be significantly greater than those for Group IIT (Δ > 0.7) (P = .01).
UNASSIGNED: These findings indicate that either a PPTS approximating the preoperative PTS or a slightly flattened PPTS in comparison (Δ < 0.7) is associated with WBROM greater than 130°. Values for axial rotation and anterior sliding were not significantly associated with changes to the PTS.
摘要：
■全膝关节置换术（TKA）后，正常的膝关节运动学很少被复制。保留两个交叉韧带（双交叉保留TKA）对此有所帮助。术后胫骨后倾斜（PPTS）可能进一步影响韧带张力和运动学。这项研究的目的是确定术前胫骨后斜率（PTS）和PPTS之间的变化如何影响膝关节运动学。
■使用标准仪器进行20个双杂物保留TKAs。在步态和单个膝盖弯曲期间获得荧光透视运动学数据。术前和PPTS的影像学测量之间的差异（Δ）与体内膝关节运动学相关。根据其Δ值将患者分为2组。第一组由小于0.7的Δ值组成，表明与术前PTS相比相似的PPTS或稍微平坦的PPTS。第II组由高于0.7的Δ值组成，表明PPTS变陡。
■术前PTS值范围为-0.5°至11.2°，平均值为5.0°±3.4°。PPTS值范围为3.0°至12.1°,平均为7.1°±3.1°。从94°到139°测量的负重运动范围（WBROM），股骨胫骨轴向旋转范围为-2.9°至17.3°。t检验显示，IT组（Δ<0.7）中WBROM的平均值明显大于IIT组（Δ>0.7）（P=0.01）。
■这些发现表明，与术前PTS近似的PPTS或相比之下略微平坦的PPTS（Δ<0.7）与大于130°的WBROM相关。轴向旋转和前滑动的值与PTS的变化没有显着相关。
■使用标准仪器进行20个双杂物保留TKAs。在步态和单个膝盖弯曲期间获得荧光透视运动学数据。术前和PPTS的影像学测量之间的差异（Δ）与体内膝关节运动学相关。根据其Δ值将患者分为2组。第一组由小于0.7的Δ值组成，表明与术前PTS相比相似的PPTS或稍微平坦的PPTS。第II组由高于0.7的Δ值组成，表明PPTS变陡。
■术前PTS值范围为-0.5°至11.2°，平均值为5.0°±3.4°。PPTS值范围为3.0°至12.1°,平均为7.1°±3.1°。从94°到139°测量的负重运动范围（WBROM），股骨胫骨轴向旋转范围为-2.9°至17.3°。t检验显示，IT组（Δ<0.7）中WBROM的平均值明显大于IIT组（Δ>0.7）（P=0.01）。
■这些发现表明，与术前PTS近似的PPTS或相比之下略微平坦的PPTS（Δ<0.7）与大于130°的WBROM相关。轴向旋转和前滑动的值与PTS的变化没有显着相关。
