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Measuring the pressure pattern of the joint surface in the uninjured knee

Messung der Gelenksflächendruckverteilung im unverletzten Kniegelenk

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Zusammenfassung

Ziel der Studie

Überprüfung eines intraoperativ einsatzbaren Oberflächendruckmesssystems unter Simulation von Operationssaalbedingungen.

Art der Studie

Leichenexperiment.

Material und Methoden

An fünf Leichen wurden die Messproben (K 6900 quad probes) medial und lateral in das Kniegelenk eingeführt. Das Messsystem ermöglicht Datenerfassung in Echtzeit und EDV-gestützte Datenerfassung (K-scan system,Hersteller: Tekscan Inc., South Boston, MA). Initial befand sich das Knie hängend in 90° Beugung in der selben Position wie in einem leg-holder. Dann wurde das Knie manuell bis 0° gestreckt und wieder in Beugung gebracht. Die Daten werden als Relativwerte angegeben, da sie als Grundlage für intraoperative Messungen dienen sollen. Die Absolutwerte würden während der Arthroskopie durch den Druck der Arthroskopiepumpe laufend verändert werden.

Ergebnisse

Das initiale Verhältnis des Gelenksflächendrucks in 90° Beugung war 1∶1,5 zwischen dem medialen und dem lateralen Gelenksspalt. Während der Streckung stieg der Druck im medialen Gelenksabschnitt und erreichte 1∶1 bei circa 15°, bei voller Streckung lag das Verhältnis bei 1,8∶1 zwischen medial und lateral. Bei der Rückführung des Unterschenkels wurde eine ähnliche Gelenksflächendruckverteilung aufgezeichnet.

Zusammenfassung

Unter Operationssaalbedingungen ist die Gelenksflächendruckverteilung zwischen dem medialen und lateralen Kniecompartment ist messbar und reproduzierbar. Der Einsatz der Gelenksflächendruckmessung während der Implantation eines Ersatztransplantates für das vordere Kreuzband könnte Daten für eine intraoperative individuelle Qualitätskontrolle liefern.

Summary

Purpose

Testing an applicable intraoperative system for measuring surface pressure in knee joints, simulating as accurately as possible operating theatre conditions.

Type of study

Cadaver study.

Methods

Pressure probes were introduced into the knee joints medially and laterally (K 6900 quad probes) in five cadavers, providing real-time data with computerized data recording (K-scan system, manuf. Tekscan Inc., South Boston, MA). The initial position of the knee was flexed and hanging, as in a leg holder. In simulation of usual operating theatre procedures, the knee was manually extended to 0° and again brought to hanging position. The data are given as relative-pressure values and shouldserve as the basis for intraoperative use. During arthroscopy, absolute-pressure values would then be influenced by the pressure of the arthroscopy pump.

Results

In 90° flexion the average pressure ratio between the medial and lateral joint compartments was initially 1∶1.5. When the leg was brought to full extension the pressure in the medial compartment increased, giving a pressure ratio of 1∶1 at about 15° and 1.8∶1 at full extension. When bringing the leg back again to 90° a similar pressure ratio curve was recorded.

Conclusions

The pressure relationship between the medial and lateral knee compartments could be recorded and was found reproducible in simulated operating-theatre conditions. The measurement of joint surface pressure during implantation of an anterior cruciate ligament graft could provide data for individual intraoperative quality control, thus improving surgical results.

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Authors and Affiliations

  1. Department of Traumatology, KH St. Pölten, St. Pölten, Austria

    Martin Fuchs

  2. Department of Traumatology, University of Vienna Medical School, AKH, Währinger Gürtel 18-20, A-1090, Vienna, Austria

    Richard K. Kdolsky, Basil Al Arabid, Rudolf Schabus & Vilmos Vécsei

Authors
  1. Richard K. Kdolsky
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  2. Basil Al Arabid
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  3. Martin Fuchs
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  4. Rudolf Schabus
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  5. Vilmos Vécsei
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Correspondence to Richard K. Kdolsky.

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Kdolsky, R.K., Arabid, B.A., Fuchs, M. et al. Measuring the pressure pattern of the joint surface in the uninjured knee. Wien Klin Wochenschr 116, 196–200 (2004). https://doi.org/10.1007/BF03040487

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  • DOI: https://doi.org/10.1007/BF03040487

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