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[1]鄧曉冬.國人全膝關(guān)節(jié)置換術(shù)中股骨遠端旋轉(zhuǎn)對線方法的研究[J].中醫(yī)正骨,2014,26(08):3-7.
　Deng Xiaodong*.Study on distal femur rotational alignment method in the total knee arthroplasty(TKA)for Chinese people[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(08):3-7.
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國人全膝關(guān)節(jié)置換術(shù)中股骨遠端旋轉(zhuǎn)對線方法的研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期數(shù):
2014年08期
頁碼:
3-7
欄目:
臨床研究
出版日期:
2014-08-30

文章信息/Info

Title:
Study on distal femur rotational alignment method in the total knee arthroplasty(TKA)for Chinese people
作者:
鄧曉冬
四川省資陽市第一人民醫(yī)院,四川 資陽 641300
Author(s):
Deng Xiaodong*
The Ziyang First People's Hospital,Ziyang 641300,Sichuan,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 膝 股骨遠端 旋轉(zhuǎn)對線 磁共振成像
Keywords:
Arthroplasty; replacement; knee;  Distal femur;  Rotational alignment;  Magnetic resonance imaging
摘要:
目的:探討國人正常股骨遠端旋轉(zhuǎn)對線各個標志的臨床意義。方法:將80例志愿者160個正常膝關(guān)節(jié),按性別分為2組,并按側(cè)別為左、右側(cè)組。然后采用MRI掃描膝關(guān)節(jié),依據(jù)Dalury方法獲取脛骨矢狀位、冠狀位圖像,將圖像輸入電腦建立股骨遠端三維重建圖像; 在三維重建圖像上測量4條軸線及4條軸線所形成的5個夾角。分別比較男、女組及左、右側(cè)組臨床上髁軸線與外科上髁軸線夾角、髁扭轉(zhuǎn)角、前后軸線的垂線與外科上髁軸線夾角、股骨后髁角。結(jié)果:男性組股骨后髁角、髁扭轉(zhuǎn)角、前后軸線的垂線與外科上髁軸線夾角均大于女性組[3.26°±0.47°; 2.76°±1.51°,t=4.125,P=0.000; 6.21°±0.73°,5.71°±0.92°,t=4.125,P=0.000; 0.32°±0.63°,1.18°±0.59°,t=5.165,P=0.000]; 男性組與女性組前后軸線的垂線與后髁軸線夾角、臨床上髁軸線與外科上髁軸線夾角比較,組間差異無統(tǒng)計學意義[4.65°±0.61°,4.27°±0.27°,t=1.389,P=0.141; 2.64°±0.51°,2.98°±0.78°,t=1.821,P=0.078]。左側(cè)組股骨后髁角、髁扭轉(zhuǎn)角、前后軸線的垂線與外科上髁軸線夾角、前后軸線的垂線與后髁軸線夾角、臨床上髁軸線與外科上髁軸線夾角與右側(cè)組比較,差異均無統(tǒng)計學意義[3.22°±0.88°,3.43°±1.02°,t=0.081,P=0.930; 6.18°±1.25°,6.41°±1.53°,t=0.035,P=1.105; 4.37°±0.46°,4.12°±0.61°,t=0.000,P=0.815; 0.85°±0.62°,0.81°±0.56°,t=0.497,P=0.926; 2.69°±0.71°,2.72°±0.79°,t=0.121,P=0.835]。結(jié)論:國人正常股骨遠端旋轉(zhuǎn)對線標志存性別差異,但不存在側(cè)別差異; 這提示在全膝關(guān)節(jié)置換術(shù)中應(yīng)根據(jù)具體情況選擇股骨遠端旋轉(zhuǎn)對線的軸線,以確保患者在術(shù)后獲得良好的治療效果。
Abstract:
Objective:To explore the clinical significance of normal distal femur rotational alignment anatomic landmark in Chinese people.Methods:Eighty volunteer with 160 normal knee-joints were divided into 2 groups according to their gender and they were also divided into left side group and right side group.Then the knee joints were scaned by MRI,and the sagittal and coronary images were obtained by using the Dalury method.The images were inputed into the computer to build 3D reconstructed images of distal femur and the four axes and the five angles formed by the four axes were measured on the 3D reconstructed images.The angle between CTEA and STEA(CSA),the condylar twist angle(CTA),the angle between the perpendicular of APL and STEA(ATA)and the posterior condylar angle(PCA)were compared between male group and female group and between left side group and right side group respectively.Results:The PCA,CTA and ATA of male group were all greater than that of female group(3.26+/-0.47 vs 2.76+/-1.51 degrees,t=4.125,P=0.000; 6.21+/-0.73 vs 5.71+/-0.92 degrees,t=4.125,P=0.000; 0.32+/-0.63 vs 1.18+/-0.59 degrees,t=5.165,P=0.000).There was no statistical difference in APA and CSA between male group and female group(4.65+/-0.61 vs 4.27+/-0.27 degrees,t=1.389,P=0.141; 2.64+/-0.51 vs 2.98+/-0.78 degrees,t=1.821,P=0.078).There was no statistical difference in PCA,CTA,ATA,APA and CSA between left side group and right side group(3.22+/-0.88 vs 3.43+/-1.02 degrees,t=0.081,P=0.930; 6.18+/-1.25 vs 6.41+/-1.53 degrees,t=0.035,P=1.105; 4.37+/-0.46 vs 4.12+/-0.61 degrees,t=0.000,P=0.815; 0.85+/-0.62 vs 0.81+/-0.56 degrees,t=0.497,P=0.926; 2.69+/-0.71 vs 2.72+/-0.79 degrees,t=0.121,P=0.835).Conclusion:There is gender difference in normal distal femur rotational alignment anatomic landmark in Chinese people while there is no side difference.Therefore,the axes of distal femur rotational alignment should be chosen according to the specific conditions in TKA,so as to ensure good therapeutic effect after the treatment.

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更新日期/Last Update: 2014-08-30