使用动态紧张器建立股骨部件旋转并不能改善在使用解剖植入物进行全膝关节置换后的软骨位置:一项病例对照研究
Bartosz M Maciąg1, Bartłomiej Wilk1, Mateusz Nawrocki1
1Department of Orthopedics and Rehabilitation, Międzyleski Specialist Hospital, Medical University of Warsaw, Warsaw, Poland.
The Knee
|May 11, 2024
概括
与标准方法相比,动态紧张器在全膝关节置换 (TKR) 后没有改善皮带位置. 虽然一些患者报告的结果和早期运动范围 (ROM) 显示出轻微的好处,但前膝关节疼痛 (AKP) 和长期ROM并没有显著差异.
科学领域:
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
- 膝盖生物力学 膝盖生物力学
背景情况:
- 前膝关节疼痛 (AKP) 是全膝关节置换 (TKR) 后不满的一个常见原因.
- 骨关节功能障碍,可能是由于不适当的植入物组件旋转,是AKP的疑似原因.
- 精确的骨定位对于最佳的TKR结果至关重要.
研究的目的:
- 使用动态张力器分析标准测量切除后的骨位置,TKR与TKR相比.
- 评估前膝关节疼痛 (AKP) 的频率,运动范围 (ROM) 和患者报告的结果.
- 为了比较术后6周和3个月的临床结果.
主要方法:
- 一项对127名接受TKR的患者进行比较研究.
- 研究组 (89名患者) 使用了FUZION动态张力器;对照组 (38名患者) 使用了标准的TKR.
- 所有患者都接受了固的PERSONA MC,没有骨重新表面化;成像 (X射线,CT) 评估了组件对齐.
主要成果:
- 群体之间没有显著的骨定位角度差异 (PCA-patella,sTEA-patella,PCA-sTEA).
- 患者的比例没有显著差异>3° 骨倾斜.
- 动态紧张组在被遗忘的联合分数和早期的ROM中显示出统计学上显著的改善,但在后来的ROM或AKP/WOMAC分数中没有.
结论:
- 使用动态紧张器与标准的股骨部件外部旋转相比,并不能提供更准确的状面部相对于后状轴 (PCA) 的定位.
- 与动态张力器没有证明对AKP和长期ROM的临床益处.
- 可能需要进一步的研究来探索替代技术,以优化TKR中的骨骨关节跟踪.
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