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Objective To compare the differences in lower limb force line between degenerative medial meniscus injuries and lateral meniscus injuries and investigate their correlation.Methods A total of 90 patients who underwent arthroscopic treatment for meniscal injuries between March 2019 and March 2022 were enrolled in the study.They were 45 males and 45 females,at a median age of 52 years(ranging from 40 to 59 years).Of these patients,47 had medial meniscus injuries,while 43 had lateral meniscus injuries.The hip-knee-ankle(HKA)angle was measured on full-length films,and the differences were compared between the 2 groups.Results There were no significant differences in terms of gender,age,lower limb laterality,body mass index,site of injury,and type of injury between the medial meniscus injury group and the lateral meniscus injury group.Statistical difference was observed in the mean HKA angle,with a value of(177.20±2.46)° in the medial meniscus injury group and of(181.05±3.13)° in the lateral meniscus injury group(P＜0.01).Conclusion There is a significant difference in HKA angle between medial meniscus injury group and the lateral meniscus injury group.A correlation is found between lower limb alignment and degenerative meniscus injury.
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BACKGROUND:In recent years,computer-assisted navigation has gradually attracted attention in the medical field.Some scholars have reported that the clinical effects of computer navigation in total knee arthroplasty vary.To explore the clinical effect of the new generation of Brainlab Knee 3 navigation system,this study is conducted. OBJECTIVE:To analyze the application effect of computer navigation system(Brainlab Knee 3)combined with gap balance technology in total knee arthroplasty. METHODS:A total of 71 patients received total knee arthroplasty at the Department of Joint Surgery of Dalian Second People's Hospital from November 2020 to May 2021.In the navigation group,35 patients underwent total knee arthroplasty by computer navigation combined with gap balance.In the traditional group,36 patients underwent osteotomy with traditional surgical instruments.The difference between medial and lateral joint spaces,knee range of motion,hospital for special surgery knee score,hip-knee-ankle angle,deviation values of coronal femoral component angle,coronal tibial component angle,and sagittal tibial component angle were compared between the two groups. RESULTS AND CONCLUSION:(1)In the navigation group,the differences of intraoperative medial and lateral joint gap at knee extension 0,1,and 2 mm were found in 19,14,and 2 cases,respectively.The gap difference was 0 mm in 18 cases,1 mm in 15 cases and 2 mm in 2 cases at 90° degree knee flexion.In the traditional group,the gap difference at knee extention was 0 mm in 10 cases,1 mm in 20 cases,and 2 mm in 6 cases.The gap difference at 90 degree knee flexion was 0 mm in 10 cases,1 mm in 15 cases and 2 mm in 8 cases.(2)The operation time in the navigation group was longer than that in the traditional group(P<0.05),and two patients in the navigation group developed lower limb intermuscular vein thrombosis after surgery,and none of the patients in the traditional group had complications.(3)The range of motion between the two groups increased significantly at 6 and 12 months after surgery,and the range of motion in the navigation group was higher than that in the traditional group(P<0.05).(4)At 12 months after surgery,the hospital for special surgery knee scores of both groups increased significantly,and the hospital for special surgery knee score in the navigation group was higher than that in the traditional group(P<0.05).(5)At 6 months after surgery,the deviation values of hip-knee-ankle angle,coronal femoral component angle,coronal tibial component angle,and sagittal tibial component angle of navigation group were significantly lower than those in the traditional group(P<0.05).(6)The results showed that computer navigation technique combined with gap balance in total knee arthroplasty had advantages in postoperative range of motion,lower limb alignment and the accuracy of tibial prosthesis component position,and joint function recovered well.
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Abstract Background: Lower limb coronal alignment was thought to be a predictive factor for Unicompartmental Knee Arthroplasty (UKA) result. The tibial bony resection and implant position lead to joint line change postoperatively. Analysis was done to find out the correlation between these factors. Methods: From 2019 to 2021, 90 medial Oxford UKA were implanted by a single surgeon. Hip Knee Ankle Angle (HKAA), Lateral Distal Femoral Angle (LDFA), Medial Proximal Tibial Angle (MPTA), and intraoperative bony resection thickness were measured. The medial joint line change was calculated. The correlation between joint line change and alignment change was evaluated. Results: The mean tibial resection thickness was 4.3 mm. The mean tibial joint line was elevated by 2.3 mm, while the mean femoral joint line proximalized by 0.8 mm. HKAA changed from 8.4° varus preoperatively to 3.6° varus postoperatively. LDFA changed from 89.0° to 86.7°. MPTA changed from 85.6° to 86.6°. Preoperative HKAA showed a strong correlation with postoperative HKAA (p < 0.001), and preoperative MPTA showed a positive correlation with postoperative HKAA (p < 0.001). While preoperative LDFA had a negative correlation with postoperative HKAA (p < 0.001). The femoral joint line change and LDFA change had a significant correlation with HKAA change (p < 0.05). Conclusion: The change of joint line had no correlation with postoperative HKAA in Oxford UKA. Preoperative HKAA strongly correlated with postoperative HKAA; while preoperative smaller LDFA and larger MPTA had a moderate correlation with postoperative HKAA. The femoral joint line change and LDFA change had a weak to moderate correlation with HKAA change.
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BACKGROUND: There are many reasons for poor function after knee arthroplasty. Leg length discrepancy is one of them. The extent of influence on the function of knee joint after arthroplasty has not been fully studied. OBJECTIVE: To analyze the change degree, possible influencing factors and functional changes of leg length discrepancy in patients after total knee arthroplasty. METHODS: Totally 107 patients (124 knees), including 23 males and 84 females, were included from October 2016 to September 2018, who entered the Department of Orthopedics of Affiliated Hospital of Xuzhou Medical University for total knee arthroplasty. There were 90 cases of unilateral total knee arthroplasty (90 knees) and 17 cases of bilateral total knee arthroplasty (34 knees). Three cases (6 knees) of bilateral total knee arthroplasty received separate treatment with an interval of more than 6 months, and entered the unilateral knee group. Therefore, there were 93 cases (96 knees) in the unilateral knee group, and 14 cases (28 knees) in the bilateral knee group. Patients signed the informed consent. This study was approved by the Hospital Ethics Committee. At preoperative and postoperative 10 days and 6 months, full length anteroposterior radiographs were taken, and the length of the lower limb and hip-knee-ankle angle were measured and recorded. Angle of knee flexion contracture was measured and the hospital for special surgery knee score was recorded. RESULTS AND CONCLUSION: (1) The length of patients' lower limbs was increased by the correction of deformities after total knee arthroplasty. The length of lower limbs 10 days after surgery was longer than that at 6 months after surgery. The lower limbs of 70.2% of the patients were increased 10 days after total knee arthroplasty, and 79.0% of the patients were increased 6 months after total knee arthroplasty. At 10 days and 6 months postoperatively, the postoperative corrected flexion contracture angles were positively correlated with the change of postoperative lower limb length. (3) Limb lengthening on the operative side was positively correlated with increased hospital for special surgery knee score after surgery. (4) The incidence of leg length discrepancy before and after surgery was almost equal: 45.1 % preoperatively, 55.3% 10 days postoperatively, and 46.0% 6 months postoperatively. (5) The leg length discrepancy preoperatively and 6 months postoperatively was influenced by the difference of deformities between the pair of limbs. Preoperative influencing factors were the difference of hip-knee-ankle angle and flexion contracture of both lower limbs. The difference value of flexion contracture of both lower limbs was the factor affecting the leg length discrepancy 6 months after surgery. Leg length discrepancy before surgery and 6 months after surgery was affecting the difference of hospital for special surgery knee score between lower limbs.