METHODS: Two groups of patients were studied, one with PCL retention (22 patients) and the other with PCL resection (25 patients), while kneeling at 90º flexion. Following 3D model-to-2D image registration, A-P displacements of both femoral condyles were determined relative to the dwell point of the medial socket.
RESULTS: With PCL resection versus PCL retention, the medial femoral condyle was 5.1 ± 3.7 mm versus 0.8 ± 2.1 mm anterior of the dwell point (p < 0.0001). Patient-reported function scores were comparable (p ≥ 0.1610) despite a significantly shorter follow-up of 7.8 ± 0.9 months with PCL retention than 19.6 ± 4.9 months with PCL resection (p < 0.0001). Range of motion was 126 ± 8° versus 122 ± 6° with and without PCL retention, respectively (p = 0.057).
CONCLUSIONS: Surgeons that use a highly conforming tibial insert design can stabilize the medial femoral condyle during kneeling by retaining the PCL. In patients with PCL resection, the 9 mm high anterior lip of the insert with ball-in-socket medial conformity was insufficient to prevent significant anterior displacement of the medial femoral condyle when weight-bearing on the anterior tibia.
方法:对两组患者进行研究,一个PCL保留(22例),另一个PCL切除(25例),而跪在90º屈曲。在3D模型到2D图像配准之后,确定两个股骨髁的A-P位移相对于内侧窝的停留点。
结果:PCL切除与PCL保留相比,股骨内侧髁为5.1±3.7mm,位于停留点前为0.8±2.1mm(p<0.0001).患者报告的功能评分具有可比性(p≥0.1610),尽管PCL保留的随访时间为7.8±0.9个月,明显短于PCL切除的19.6±4.9个月(p<0.0001)。运动范围为126±8°,而有和没有PCL保留的运动范围为122±6°。分别(p=0.057)。
结论:使用高度一致的胫骨插入物设计的外科医生可以通过保留PCL在跪下期间稳定股骨内侧髁。在PCL切除术的患者中,当在胫骨前负重时,具有球窝内侧整合的插入物的9毫米高的前唇不足以防止股骨内侧髁的明显前移。