Abstract

Our aim was to understand whether using different landmarks for tibial component rotation influenced articular contact pressures in a balanced total knee arthroplasty (TKA). Twelve patients underwent TKA (Triathlon CR, Stryker Inc., Mahwah, NJ) and contact pressures were assessed using a wireless sensor. Robotic arm assisted TKA using a functional alignment technique was performed, with balanced gaps between medial and lateral compartments. Compartment pressures were measured with the trial tibial component rotated to Akagi's line and to Insall's axis respectively. Rotating the tibial component to Akagi's line resulted in a significantly greater proportion of knees being balanced and lower contact pressures than when the tibial component was rotated to Insall's axis at 10°, 45° and 90° of flexion (p < 0.05). Medial compartment pressures were significantly increased in 10° of flexion, as were lateral compartment pressures in all positions when the tibial component was aligned to Insall's axis (p < 0.05). The mean difference in rotation observed with the two landmarks was 6.9° (range 4.1–9.1°). Rotational alignment of the tibial component using Akagi's line reduced contact pressures, improved balance and reduced the need for soft tissue release when compared with Insall's axis in robotic arm assisted TKA.

摘要

我们的目的是了解在平衡全膝关节置换术 (TKA) 中使用不同的胫骨假体旋转标志是否影响关节接触压力。12 名患者接受了 TKA（Triathlon CR，Stryker Inc.，Mahwah，NJ）并使用无线传感器评估接触压力。使用功能对齐技术进行机械臂辅助 TKA，内侧和外侧隔间之间的间隙平衡。将试验胫骨组件分别旋转到 Akagi 的线和 Insall 的轴来测量隔室压力。将胫骨组件旋转到 Akagi 线时，与胫骨组件在 10°、45° 和 90° 屈曲时旋转到 Insall 轴时相比，膝关节得到平衡的比例显着增加，接触压力更低（p< 0.05)。当胫骨组件与 Insall 轴对齐时，内侧室压力在 10° 弯曲时显着增加，所有位置的外侧室压力也显着增加 ( p  < 0.05)。用两个地标观察到的旋转平均差异为 6.9°（范围 4.1-9.1°）。与 Insall 的机械臂辅助 TKA 中的轴相比，使用 Akagi 线的胫骨组件的旋转对齐减少了接触压力，改善了平衡并减少了软组织释放的需要。