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IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-01-23 DOI:10.1016/j.jor.2025.01.028

Krishna Kiran Eachempati , Apurve Parameswaran , Sunil Apsingi , Chandra Sekhar Dannana , Deepak Gautam , Neil P. Sheth

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引用次数: 0

摘要

背景过去尚未描述过股骨后内侧髁（PMFC）在变曲骨性关节炎膝关节中的形态变化。本研究的目的是在计算机导航辅助（CAS）全膝关节置换术（TKA）中，比较前交叉韧带（ACL）功能正常和功能不全的变位骨关节炎膝关节的术前畸形、髁后轴线（PCA）相对于Whiteside轴线的旋转以及PMFC增生或萎缩的发生率。方法对 250 名连续接受 CAS TKA 治疗膝关节屈曲性骨关节炎的前交叉韧带功能健全和缺陷膝关节患者的术前膝关节屈曲畸形、PCA 相对于怀特塞德轴的旋转、PMFC 是否增生或萎缩的相关数据进行分析。结果与前交叉韧带功能健全的膝关节相比，前交叉韧带功能缺陷的膝关节术前受力（9.94° ± 6.14° 对 7.29° ± 4.48°，P < 0.001）和矫正（3.62°±4.36°对2.41°±3.08°，P< 0.001）屈曲畸形、PCA相对于Whiteside轴的内旋（4.06°±2.32°对3.08°±2.03°，P< 0.结论：膝关节外翻骨性关节炎患者长期前交叉韧带缺损可能导致冠状畸形进展、PMFC萎缩、PCA相对于Whiteside轴的内旋增加，并最终导致PMFC增生。在进行 TKA 时需要牢记这一点，以防不慎将股骨组件置于不适当的旋转位置。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Influence of the functional status of the anterior cruciate ligament on the posterior medial femoral condyle among varus osteoarthritic knees

Background

Morphologic changes in the posterior medial femoral condyle (PMFC) among varus osteoarthritic knees have not been described in the past. The aims of this study were to compare anterior cruciate ligament (ACL) competent and deficient varus osteoarthritic knees during computer-navigation assisted (CAS) total knee arthroplasty (TKA) in terms of their pre-operative deformity, rotation of the posterior condylar axis (PCA) with respect to Whiteside's axis, and prevalence of PMFC hyperplasia or attrition.

Methods

Data pertaining to pre-operative varus deformity, rotation of the PCA with respect to Whiteside's axis, and presence of PMFC hyperplasia or attrition were analyzed for 250 consecutive patients each, with ACL-competent and deficient knees, who underwent CAS TKA for varus osteoarthritis of the knee.

Results

ACL-deficient knees, compared to ACL-competent knees, were associated with greater pre-operative stressed (9.94° ± 6.14° versus 7.29° ± 4.48°, P < 0.001) and corrected (3.62° ± 4.36° versus 2.41° ± 3.08°, P < 0.001) varus deformities, internal rotation of the PCA with respect to Whiteside's axis (4.06° ± 2.32° versus 3.08° ± 2.03°, P < 0.001), and prevalence of PMFC attrition (8.4 % versus 0 %, P < 0.001) and hyperplasia (27.2 % versus 9.6 %, P < 0.001).

Conclusion

Chronic ACL deficiency in varus osteoarthritic knees may result in progression of the coronal deformity, PMFC attrition, increased internal rotation of the PCA with respect to Whiteside's axis, and eventually PMFC hyperplasia. This needs to be borne in mind during TKA to prevent inadvertent placement of the femoral component in inappropriate rotation.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.