Abstract：
OBJECTIVE: The progression of osteoarthritis in lateral compartment has been identified as a primary complication in medial unicompartmental knee arthroplasty (UKA) revisions, irrespective of whether employing fixed bearing (FB) or mobile bearing (MB) designs. Compared to the previous contact point analyses, the tibiofemoral contacts during knee movements are comprehended by a more comprehensive understanding of joint spaces. This study aims to dynamically map the joint spaces in the lateral compartment during the single-leg lunge following FB and MB UKA procedures, and compare them with the respective contralateral native knees. It is hypothesized that the significant change in joint space for post-UKA compared to their native knees.
METHODS: Twelve patients with unilateral medial FB UKA and eleven patients with unilateral medial MB UKA were included and underwent computed tomography scans. The exclusion criteria included anterior cruciate ligament deficiency, postoperative knee pain, any postoperative complications, and musculoskeletal illnesses. A dual fluoroscopic imaging system was utilized to capture the single-leg lunge, and 2D-to-3D registration facilitated the visualization of knee motion. According to the knee motions, joint spaces on tibial and femoral surfaces in the lateral compartments of native, FB, and MB UKA knees were calculated and mapped.
RESULTS: In comparison to the native knees, FB UKA knees exhibited significant increases in medial, lateral, central, and posterior joint spaces in the lateral compartment (p < 0.05), while MB UKA knees showed significant increases only in central and posterior joint spaces (p < 0.05). Moreover, FB UKA demonstrated greater increases in medial, central, and posterior joint spaces compared to MB UKA. Tibial varus and valgus during lunges, as well as the Oxford Knee Score (OKS) and Hip-Knee-Ankle angle (HKA), correlated with joint spaces.
CONCLUSIONS: Dynamic joint space analysis provided a more comprehensive insight into contact dynamics. FB UKA led to an enlargement of joint spaces, whereas MB UKA resulted in joint spaces closer to native knees. These findings contribute to understanding potential postoperative complication in UKAs.
METHODS: Twelve patients with unilateral medial FB UKA and eleven patients with unilateral medial MB UKA were included and underwent computed tomography scans. The exclusion criteria included anterior cruciate ligament deficiency, postoperative knee pain, any postoperative complications, and musculoskeletal illnesses. A dual fluoroscopic imaging system was utilized to capture the single-leg lunge, and 2D-to-3D registration facilitated the visualization of knee motion. According to the knee motions, joint spaces on tibial and femoral surfaces in the lateral compartments of native, FB, and MB UKA knees were calculated and mapped.
RESULTS: In comparison to the native knees, FB UKA knees exhibited significant increases in medial, lateral, central, and posterior joint spaces in the lateral compartment (p < 0.05), while MB UKA knees showed significant increases only in central and posterior joint spaces (p < 0.05). Moreover, FB UKA demonstrated greater increases in medial, central, and posterior joint spaces compared to MB UKA. Tibial varus and valgus during lunges, as well as the Oxford Knee Score (OKS) and Hip-Knee-Ankle angle (HKA), correlated with joint spaces.
CONCLUSIONS: Dynamic joint space analysis provided a more comprehensive insight into contact dynamics. FB UKA led to an enlargement of joint spaces, whereas MB UKA resulted in joint spaces closer to native knees. These findings contribute to understanding potential postoperative complication in UKAs.
摘要：
目的：外侧间室骨关节炎的进展已被确定为内侧单室膝关节置换术（UKA）修订的主要并发症，无论采用固定轴承(FB)还是移动轴承(MB)设计。与以前的接触点分析相比，通过对关节空间的更全面的了解，可以理解膝关节运动过程中的胫骨股接触。本研究旨在动态绘制FB和MBUKA手术后单腿弓步时外侧隔室的关节空间，并将它们与各自的对侧天然膝盖进行比较。假设UKA后的关节空间与他们的天然膝盖相比发生了显着变化。
方法：纳入了12例单侧内侧FBUKA患者和11例单侧内侧MBUKA患者，并进行了计算机断层扫描。排除标准包括前交叉韧带缺陷,术后膝关节疼痛，任何术后并发症，和肌肉骨骼疾病。双荧光成像系统被用来捕获单腿弓步，和2D到3D配准促进了膝盖运动的可视化。根据膝盖的动作,在胫骨和股骨表面的关节空间外侧隔室的天然，FB,计算和绘制MBUKA膝盖。
结果：与原生膝盖相比，FBUKA膝盖表现出内侧显着增加，横向,中央,和外侧隔室的后关节间隙（p<0.05），而MBUKA膝关节仅在中央和后关节间隙显着增加（p<0.05）。此外，FBUKA表现出更大的内侧增加，中央,与MBUKA相比，关节后间隙。弓步时的胫骨内翻和外翻，以及牛津膝关节评分(OKS)和髋膝关节角度(HKA)，与关节空间相关。
结论：动态关节空间分析为接触动力学提供了更全面的见解。FBUKA导致关节空间扩大，而MBUKA导致关节间隙更接近天然膝盖。这些发现有助于了解UKA的潜在术后并发症。
方法：纳入了12例单侧内侧FBUKA患者和11例单侧内侧MBUKA患者，并进行了计算机断层扫描。排除标准包括前交叉韧带缺陷,术后膝关节疼痛，任何术后并发症，和肌肉骨骼疾病。双荧光成像系统被用来捕获单腿弓步，和2D到3D配准促进了膝盖运动的可视化。根据膝盖的动作,在胫骨和股骨表面的关节空间外侧隔室的天然，FB,计算和绘制MBUKA膝盖。
结果：与原生膝盖相比，FBUKA膝盖表现出内侧显着增加，横向,中央,和外侧隔室的后关节间隙（p<0.05），而MBUKA膝关节仅在中央和后关节间隙显着增加（p<0.05）。此外，FBUKA表现出更大的内侧增加，中央,与MBUKA相比，关节后间隙。弓步时的胫骨内翻和外翻，以及牛津膝关节评分(OKS)和髋膝关节角度(HKA)，与关节空间相关。
结论：动态关节空间分析为接触动力学提供了更全面的见解。FBUKA导致关节空间扩大，而MBUKA导致关节间隙更接近天然膝盖。这些发现有助于了解UKA的潜在术后并发症。
