Comparison Of The Techniques Determining The Rotatin Of Tibial Component At TKA

Objective:Comparison of total knee arthroplasty, tibia prosthesis rotation method of line, seeking better tibial prosthesis rotating positioning method, improve the TKA surgery joint stability, activity and service life.Methods:In March 2013 to September 2014,45 cases of knee osteoarthritis patients with total knee replacement (posterior cruciate ligament replacement type cement rotary artificial knee joint), the male 17 cases,28 cases female, aged 55 to 80 years old. In hospital time sequence, the random orientation method, divided into three groups, each group of 15 patients. Intraoperative tibial prosthesis positioning methods:group Awith tibial tubercle within 1/3 as A reference, in group B with ROM (Range - Of - Motion) technology as a reference, the tibia rear axle as a reference. Preoperative and postoperative evaluation of knee joint function, intraoperative measurement of three groups of polyethylene prosthesis gasket rotation Angle. Metering data as mean ± standard deviation, using SPSS17.0 statistical software for statistical analysis, the comparison between groups using ANOVA,t-test analysisto compare groups within each group, p value<0.05 identified as statistical significance.Result:In group A、B and C, preoperative HSS score (44.3±4.0,44.8±4.1,44.5±3.5), preoperative patellar score (12.9±1.9,12.6±2.1,11.6±2.0), preoperative FTA (8.9±2.7°,9.7±3.2°, 9.2±3.1°), preoperative angle Q (20.6±2.7°,19.8±2.4°,19.5±2.5°). Postoperative HSS score (86.7±3.8,86.8±3.5,89.4±2.3), postoperative patellar score (19.6±2.4,19.6±1.6, 20.9±2.6), postoperative FTA (6.2±1.9°,5.7±1.6°,5.8±1.5°), postoperative angle Q (15.7±1.7°,14.8±1.6°,15.5±1.8°). In the two groups was not statistically significant (P> 0.05), preoperative and postoperative was statistically significant (P<0.05). A group of patients with meniscal polyethylene gasket average pronation (10.1±2.7)°.Group B patients polyethylene meniscal gaskets average pronation (0.8±2.8)°. Group C patients polyethylene meniscal gaskets average pronation(0.65±2.6)°. A and B, A and C was statistically significant,the P<0.05; B and C showed no statistical significance,the P>0.05.Conclusion:In total knee arthroplasty, the use within the middle third of the tibial tubercle positioning method, compared with the position of the femoral prosthesis, it appears excessive tibial external rotation greater chance; when using the ROM method, if femoral prosthesis position accurately and sufficiently row soft tissue release, its myopia and AP axis overlap, can obtain a more accurate alignment between both sides of the prosthesis.