PRACA ORYGINALNA
Radiological measurement of posterior tibial subluxation as a preoperative factor in choosing the type of implant in primary total knee arthroplasty
1
Department of Orthopedics and Rehabilitation, Międzyleski Specialist Hospital, Medical University of Warsaw, Poland
Zaznaczeni autorzy mieli równy wkład w przygotowanie tego artykułu
Data nadesłania: 08-03-2024
Data ostatniej rewizji: 15-04-2024
Data akceptacji: 20-06-2024
Data publikacji online: 02-07-2024
Autor do korespondencji
Dawid Jegierski
Dawid Jegierski, Department of Orthopedics and Rehabilitation, Międzyleski Specialist Hospital, Medical University of Warsaw, 2 Bursztynowa St., 04-749 Warsaw, Poland, e-mail: jegierski.dawid@gmail.com
Dawid Jegierski, Department of Orthopedics and Rehabilitation, Międzyleski Specialist Hospital, Medical University of Warsaw, 2 Bursztynowa St., 04-749 Warsaw, Poland, e-mail: jegierski.dawid@gmail.com
SŁOWA KLUCZOWE
DZIEDZINY
Choroba zwyrodnieniowa stawów Ocena aktywności choroby i jakości życia w chorobach reumatycznychDiagnostyka laboratoryjna I obrazowa chorób reumatycznychRehabilitacja
STRESZCZENIE
Introduction:
Total knee arthroplasty (TKA) is the most effective treatment of late osteoarthritis (OA) and is considered among the most successful surgical procedures in general. However, about 20% of patients remain dissatisfied. An important aspect of TKA is the proper choice of implant type – posterior stabilized (PS) or cruciate retaining (CR). Both have their indications for use based on intraoperative functional examination, but no objective radiological criteria have yet been developed. The aim of this study was to investigate the relationship between the posterior subluxation of the tibia on preoperative radiograms and implant type used.
Material and methods:
A series of 52 patients undergoing TKA were included in the study. All patients were over 50 years old, had clinically and radiologically confirmed primary OA of grade IV on the Kellgren-Lawrence scale and were undergoing a primary total knee replacement (TKR) with a PS or CR design. Preoperative lateral radiographs were analysed retrospectively. The tibial translation ratio was calculated as a percentage of subluxation in the length of the tibial plateau.
Results:
There were no significant differences between implant types in regard to investigated parameters. However, there was a significant difference between the groups CR and PS in regard to age (68.5 [60.0–72.0] vs. 72.5 [68.0–75.0], p = 0.006).
Conclusions:
This study revealed that preoperative tibial translation does not significantly correlate with the choice of implant type and so probably not with posterior cruciate ligament (PCL) function and efficiency either. Additionally, this study showed that PCL insufficiency is related to the age of the patients, because of the more frequent choice of the PS implant type for the surgery in older patients than in the case of the CR implant type.
Total knee arthroplasty (TKA) is the most effective treatment of late osteoarthritis (OA) and is considered among the most successful surgical procedures in general. However, about 20% of patients remain dissatisfied. An important aspect of TKA is the proper choice of implant type – posterior stabilized (PS) or cruciate retaining (CR). Both have their indications for use based on intraoperative functional examination, but no objective radiological criteria have yet been developed. The aim of this study was to investigate the relationship between the posterior subluxation of the tibia on preoperative radiograms and implant type used.
Material and methods:
A series of 52 patients undergoing TKA were included in the study. All patients were over 50 years old, had clinically and radiologically confirmed primary OA of grade IV on the Kellgren-Lawrence scale and were undergoing a primary total knee replacement (TKR) with a PS or CR design. Preoperative lateral radiographs were analysed retrospectively. The tibial translation ratio was calculated as a percentage of subluxation in the length of the tibial plateau.
Results:
There were no significant differences between implant types in regard to investigated parameters. However, there was a significant difference between the groups CR and PS in regard to age (68.5 [60.0–72.0] vs. 72.5 [68.0–75.0], p = 0.006).
Conclusions:
This study revealed that preoperative tibial translation does not significantly correlate with the choice of implant type and so probably not with posterior cruciate ligament (PCL) function and efficiency either. Additionally, this study showed that PCL insufficiency is related to the age of the patients, because of the more frequent choice of the PS implant type for the surgery in older patients than in the case of the CR implant type.
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