Sahil Prabhnoor Sidhu, Brent Lanting, Paul Kelly, Edward Vasarhelyi, Ryan Willing
{"title":"在全膝关节置换术中，试用胫骨植入物可能会导致膝关节运动学与最终的Poly植入物不同。","authors":"Sahil Prabhnoor Sidhu, Brent Lanting, Paul Kelly, Edward Vasarhelyi, Ryan Willing","doi":"10.2147/ORR.S309995","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Trialling is a key step in total knee arthroplasty (TKA) and helps the surgeon assess for adequate balancing, range of motion, and stability. Despite this, there are no studies investigating knee kinematics when using trial versus final polyethylene tibial inserts.</p><p><strong>Materials and methods: </strong>Fourteen fresh frozen cadaveric specimens were cycled in a VIVO joint motion simulator. Using both simple compression and simulated muscle loads, joints were tested after TKA with a trial insert or a final tibial poly insert. Anterior/posterior (AP), internal/external (IE), and varus/valgus (VV) kinematics and laxities were analyzed.</p><p><strong>Results: </strong>Knees with trial poly inserts had significantly greater AP hysteresis (difference between flexion and extension motion) than those with final poly inserts (p=0.001). There was no significant difference in IE (p=0.563) or VV (p=0.580) hysteresis. There was no difference in AP, IE, or VV motion or laxities when considering the flexion path alone. Prosthetic joints followed different paths in flexion versus extension.</p><p><strong>Conclusion: </strong>While trial tibial inserts impart valuable information, they may not accurately reproduce the same joint kinematics as final inserts. Balancing of the knee at specific degrees of flexion may depend on the path taken to get there.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"81-88"},"PeriodicalIF":1.7000,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/5f/orr-13-81.PMC8253892.pdf","citationCount":"0","resultStr":"{\"title\":\"Trial Tibial Inserts May Result in Different Knee Kinematics from Final Poly Inserts in Total Knee Arthroplasty.\",\"authors\":\"Sahil Prabhnoor Sidhu, Brent Lanting, Paul Kelly, Edward Vasarhelyi, Ryan Willing\",\"doi\":\"10.2147/ORR.S309995\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Trialling is a key step in total knee arthroplasty (TKA) and helps the surgeon assess for adequate balancing, range of motion, and stability. Despite this, there are no studies investigating knee kinematics when using trial versus final polyethylene tibial inserts.</p><p><strong>Materials and methods: </strong>Fourteen fresh frozen cadaveric specimens were cycled in a VIVO joint motion simulator. Using both simple compression and simulated muscle loads, joints were tested after TKA with a trial insert or a final tibial poly insert. Anterior/posterior (AP), internal/external (IE), and varus/valgus (VV) kinematics and laxities were analyzed.</p><p><strong>Results: </strong>Knees with trial poly inserts had significantly greater AP hysteresis (difference between flexion and extension motion) than those with final poly inserts (p=0.001). There was no significant difference in IE (p=0.563) or VV (p=0.580) hysteresis. There was no difference in AP, IE, or VV motion or laxities when considering the flexion path alone. Prosthetic joints followed different paths in flexion versus extension.</p><p><strong>Conclusion: </strong>While trial tibial inserts impart valuable information, they may not accurately reproduce the same joint kinematics as final inserts. Balancing of the knee at specific degrees of flexion may depend on the path taken to get there.</p>\",\"PeriodicalId\":19608,\"journal\":{\"name\":\"Orthopedic Research and Reviews\",\"volume\":\"13 \",\"pages\":\"81-88\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2021-06-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/5f/orr-13-81.PMC8253892.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Orthopedic Research and Reviews\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/ORR.S309995\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Orthopedic Research and Reviews","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/ORR.S309995","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Trial Tibial Inserts May Result in Different Knee Kinematics from Final Poly Inserts in Total Knee Arthroplasty.
Introduction: Trialling is a key step in total knee arthroplasty (TKA) and helps the surgeon assess for adequate balancing, range of motion, and stability. Despite this, there are no studies investigating knee kinematics when using trial versus final polyethylene tibial inserts.
Materials and methods: Fourteen fresh frozen cadaveric specimens were cycled in a VIVO joint motion simulator. Using both simple compression and simulated muscle loads, joints were tested after TKA with a trial insert or a final tibial poly insert. Anterior/posterior (AP), internal/external (IE), and varus/valgus (VV) kinematics and laxities were analyzed.
Results: Knees with trial poly inserts had significantly greater AP hysteresis (difference between flexion and extension motion) than those with final poly inserts (p=0.001). There was no significant difference in IE (p=0.563) or VV (p=0.580) hysteresis. There was no difference in AP, IE, or VV motion or laxities when considering the flexion path alone. Prosthetic joints followed different paths in flexion versus extension.
Conclusion: While trial tibial inserts impart valuable information, they may not accurately reproduce the same joint kinematics as final inserts. Balancing of the knee at specific degrees of flexion may depend on the path taken to get there.
期刊介绍：
Orthopedic Research and Reviews is an international, peer-reviewed, open-access journal focusing on the patho-physiology of the musculoskeletal system, trauma, surgery and other corrective interventions to restore mobility and function. Advances in new technologies, materials, techniques and pharmacological agents will be particularly welcome. Specific topics covered in the journal include: Patho-physiology and bioengineering, Technologies and materials science, Surgical techniques, including robotics, Trauma management and care, Treatment including pharmacological and non-pharmacological, Rehabilitation and Multidisciplinarian care approaches, Patient quality of life, satisfaction and preference, Health economic evaluations. The journal welcomes submitted papers covering original research, basic science and technology, clinical studies, reviews and evaluations, guidelines, expert opinion and commentary, case reports and extended reports.
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