Bone landmarks are more reliable than tensioned gaps in TKA component alignment

被引:84
作者
Hanada, Hirofumi
Whiteside, Leo A.
Steiger, Jerry
Dyer-, Paul
Naito, Masatoshi
机构
[1] Missouri Bone & Joint Ctr, St Louis, MO USA
[2] Fukuoka Univ, Sch Med, Dept Orthopaed Surg, Fukuoka, Japan
关键词
D O I
10.1097/BLO.0b013e3180dc92e7
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Two distinct techniques have been used to achieve alignment and ligament balance in TKA. We hypothesized a bone landmark technique would result in normal alignment, stability, and load-bearing characteristics and that the tensioned gap technique results in malalignment. We studied 12 normal cadaveric knees (six with each technique) for stability, alignment, load-bearing stress transfer characteristics, and patellar groove position after TKA. The tensioned gap technique used tensioners to establish equal loads in the medial and lateral ligaments at 90 degrees flexion and to resect the posterior femoral surfaces parallel to the cut tibial surfaces. The bone landmarks technique aligns the anterior and posterior femoral cuts perpendicular to the median sagittal plane as defined by the anteroposterior axis and then resects bone to match implant thickness. The tensioned gap technique maintained nearly equal laxity medially and laterally but the knee shifted into varus malalignment in flexion. Compressive stress in the knee shifted medially in flexion, and the patellar groove shifted laterally. The bone landmarks technique produced near normal varus and valgus and rotational stability; alignment, patellar groove position, and load transfer characteristics remained near normal throughout flexion.
引用
收藏
页码:137 / 142
页数:6
相关论文
共 25 条
[1]
ANOUCHI YS, 1993, CLIN ORTHOP RELAT R, P170
[2]
FEMORAL ROTATIONAL ALIGNMENT, BASED ON THE ANTEROPOSTERIOR AXIS, IN TOTAL KNEE ARTHROPLASTY IN A VALGUS KNEE - A TECHNICAL NOTE [J].
ARIMA, J ;
WHITESIDE, LA ;
MCCARTHY, DS ;
WHITE, SE .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1995, 77 (09) :1331-1334
[3]
Soft-tissue balance and recovery of proprioception after total knee replacement [J].
Attfield, SF ;
Wilton, TJ ;
Pratt, DJ ;
Sambatakakis, A .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1996, 78B (04) :540-545
[4]
DORR LD, 1986, CLIN ORTHOP RELAT R, P5
[5]
Rotational malalignment of the femoral component in total knee arthroplasty [J].
Fehring, TK .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2000, (380) :72-79
[6]
ICLH ARTHROPLASTY OF KNEE - 1968-1977 [J].
FREEMAN, MAR ;
TODD, RC ;
BAMERT, P ;
DAY, WH .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1978, 60 (03) :339-344
[7]
INSALL JN, 1985, CLIN ORTHOP RELAT R, P13
[8]
INFLUENCE OF POSITIONING OF PROSTHESIS IN TOTAL KNEE REPLACEMENT [J].
LOTKE, PA ;
ECKER, ML .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1977, 59 (01) :77-79
[9]
NAGAMINE R, 2002, ORTHOP TRAUMATOL, V51, P723
[10]
Romero J, 2002, CLIN ORTHOP RELAT R, P243