无ct导航系统下全膝关节置换术中椎体保留与中位稳定假体的运动学比较

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-04-21 DOI:10.1016/j.knee.2025.04.003

Hibiki Kakiage , Shogo Hashimoto , Ryota Takase , Takeshi Shimada , Takashi Ohsawa , Hirotaka Chikuda

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引用次数: 0

摘要

背景全膝关节置换术（TKA）的运动学已被证明影响术后功能和患者满意度。与cross - stay （CR）内嵌件相比，内侧稳定（MS）内嵌件通过增强内侧稳定性和诱导侧回滚来改善运动学。本研究旨在通过无ct导航系统比较TKA中CR和MS插入物的术中运动模式。方法对21例因骨关节炎而行原发性全膝关节置换术的患者的23个膝关节进行分析。在CR和MS插入试验期间，使用无ct导航系统（BrainLab KNEE3）记录术中运动学。运动学参数，包括运动学模式，如内侧和外侧髁的前后移位和旋转角度，根据运动范围进行分析。结果MS插入体内侧AP平移明显小于CR插入体（7.0±5.0 vs. 10.3±5.1 mm, p = 0.04）。在侧位AP移位（11.5±6.2 vs. 12.8±5.2 mm, p = 0.41）、旋转角度（6.3±4.5 vs. 4.7±4.4,p = 0.20）或运动模式方面均无显著差异。结论ms插入物可通过减少内侧平移而提高稳定性。它们在重建内侧枢轴运动方面的效果与CR内嵌物相当。

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Comparison of intraoperative kinematics between cruciate-retaining and medial-stabilized inserts in total knee arthroplasty using a CT-free navigation system

Background

The kinematics of total knee arthroplasty (TKA) have been shown to affect postoperative function and patient satisfaction. A medial stabilized (MS) insert was designed to improve kinematics by enhancing medial stability and inducing lateral rollback in comparison to cruciate-retaining (CR) inserts. This study aimed to compare the intraoperative kinematic patterns between CR and MS inserts in TKA using a CT-free navigation system.

Methods

A total of 23 knees from 21 patients who underwent primary TKA for osteoarthritis were included. A CT-free navigation system (BrainLab KNEE3) was used to record intraoperative kinematics during the CR and MS insert trials. Kinematic parameters, including kinematic patterns, such as anteroposterior (AP) translation of the medial and lateral condyles and rotational angles, were analyzed based on range of motion.

Results

The MS insert exhibited significantly less medial AP translation compared to the CR insert (7.0 ± 5.0 vs. 10.3 ± 5.1 mm, p = 0.04). No significant differences were observed in the lateral AP translation (11.5 ± 6.2 vs. 12.8 ± 5.2 mm, p = 0.41), rotational angle (6.3 ± 4.5 vs. 4.7 ± 4.4, p = 0.20), or kinematic patterns.

Conclusion

MS inserts may enhance stability by reducing medial translation. Their effect on reproducing medial pivot kinematics is comparable to that of the CR inserts.

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.