山东医药
山東醫藥
산동의약
SHANDONG MEDICAL JOURNAL
2014年
16期
13-15,18
,共4页
窦勇%田伟%柳剑%杨德金%尹星华
竇勇%田偉%柳劍%楊德金%尹星華
두용%전위%류검%양덕금%윤성화
关节炎%膝关节%股骨旋转力线%股骨后髁角%股骨髁扭转角%Whiteside线
關節炎%膝關節%股骨鏇轉力線%股骨後髁角%股骨髁扭轉角%Whiteside線
관절염%슬관절%고골선전력선%고골후과각%고골과뉴전각%Whiteside선
arthritis%knee joint%femoral rotational alignment%posterior condylar angle%condylar twist angles%Whi-teside line
目的：采用三维CT测量膝骨关节炎患者远端旋转解剖标志的变化。方法选择因膝骨关节炎而行全膝关节置换术的患者75例（112膝），其中内翻型92膝（内翻组）、外翻型20膝（外翻组）；Ⅲ期股骨头坏死34例（68膝）作为正常组。回顾性分析3组术前的CT资料，采用三维CT重建的方法测量股骨与胫骨机械轴夹角（mFTA）、解剖股骨远端外翻角（aLDFA）、解剖胫骨近端内翻角（aMPTA）、股骨后髁角（PCA）、股骨髁扭转角（CTA），Whiteside线与股骨后髁连线（PCL）的夹角（WPCL）、与外科髁上轴（SEA）的夹角（WSEA）及与临床髁上轴（CEA）的夹角（WCEA）。结果内翻组mFTA、WPCL、WSEA、WCEA均高于正常组，aMPTA、PCA、CTA均低于正常组；外翻组aMPTA、PCA、CTA、WPCL、WSEA、WCEA均高于正常组，mFTA、aLDFA均低于正常组；P均＜0．05。内翻组PCA与mFTA呈负相关（r＝-0．555），与aMPTA呈正相关（r＝0．450）；外翻组PCA与mFTA呈负相关（r＝-0．614），与aLDFA呈负相关（r＝-0．719）；P均＜0．05。随着mFTA逐渐增大至15°，内翻组PCA、CTA逐渐减小，P均＜0．05。结论膝骨关节炎患者均存在Whiteside线外移；内翻型患者PCA、CTA均降低，PCA与mFTA和aMP-TA相关；外翻型患者PCA、CTA均升高，PCA与mFTA和aLDFA相关。
目的：採用三維CT測量膝骨關節炎患者遠耑鏇轉解剖標誌的變化。方法選擇因膝骨關節炎而行全膝關節置換術的患者75例（112膝），其中內翻型92膝（內翻組）、外翻型20膝（外翻組）；Ⅲ期股骨頭壞死34例（68膝）作為正常組。迴顧性分析3組術前的CT資料，採用三維CT重建的方法測量股骨與脛骨機械軸夾角（mFTA）、解剖股骨遠耑外翻角（aLDFA）、解剖脛骨近耑內翻角（aMPTA）、股骨後髁角（PCA）、股骨髁扭轉角（CTA），Whiteside線與股骨後髁連線（PCL）的夾角（WPCL）、與外科髁上軸（SEA）的夾角（WSEA）及與臨床髁上軸（CEA）的夾角（WCEA）。結果內翻組mFTA、WPCL、WSEA、WCEA均高于正常組，aMPTA、PCA、CTA均低于正常組；外翻組aMPTA、PCA、CTA、WPCL、WSEA、WCEA均高于正常組，mFTA、aLDFA均低于正常組；P均＜0．05。內翻組PCA與mFTA呈負相關（r＝-0．555），與aMPTA呈正相關（r＝0．450）；外翻組PCA與mFTA呈負相關（r＝-0．614），與aLDFA呈負相關（r＝-0．719）；P均＜0．05。隨著mFTA逐漸增大至15°，內翻組PCA、CTA逐漸減小，P均＜0．05。結論膝骨關節炎患者均存在Whiteside線外移；內翻型患者PCA、CTA均降低，PCA與mFTA和aMP-TA相關；外翻型患者PCA、CTA均升高，PCA與mFTA和aLDFA相關。
목적：채용삼유CT측량슬골관절염환자원단선전해부표지적변화。방법선택인슬골관절염이행전슬관절치환술적환자75례（112슬），기중내번형92슬（내번조）、외번형20슬（외번조）；Ⅲ기고골두배사34례（68슬）작위정상조。회고성분석3조술전적CT자료，채용삼유CT중건적방법측량고골여경골궤계축협각（mFTA）、해부고골원단외번각（aLDFA）、해부경골근단내번각（aMPTA）、고골후과각（PCA）、고골과뉴전각（CTA），Whiteside선여고골후과련선（PCL）적협각（WPCL）、여외과과상축（SEA）적협각（WSEA）급여림상과상축（CEA）적협각（WCEA）。결과내번조mFTA、WPCL、WSEA、WCEA균고우정상조，aMPTA、PCA、CTA균저우정상조；외번조aMPTA、PCA、CTA、WPCL、WSEA、WCEA균고우정상조，mFTA、aLDFA균저우정상조；P균＜0．05。내번조PCA여mFTA정부상관（r＝-0．555），여aMPTA정정상관（r＝0．450）；외번조PCA여mFTA정부상관（r＝-0．614），여aLDFA정부상관（r＝-0．719）；P균＜0．05。수착mFTA축점증대지15°，내번조PCA、CTA축점감소，P균＜0．05。결론슬골관절염환자균존재Whiteside선외이；내번형환자PCA、CTA균강저，PCA여mFTA화aMP-TA상관；외번형환자PCA、CTA균승고，PCA여mFTA화aLDFA상관。
Objective To observe the variability of distal femoral rotational landmarks of osteoarthritic knees .Meth-ods Seventy-five patients ( 112 knees ) who underwent total knee arthroplasty for osteoarthritis were chosen , including 92 varus knees ( varus group ) , 20 valgus knees ( valgus group ); and 34 patients ( 68 knees ) with stage Ⅲ necrosis of the femoral head were selected as the normal group .A retrospective analysis of three-dimensional CT reconstruction of preoper-ative data of the three groups were conducted , and the mechanical femoral tibial angle ( mFTA) , the anatomical lateral dis-tal femoral angle (aLDFA), the anatomical medial proximal tibia angle (aMPTA), the femoral posterior condylar angle (PCA), condylar twist angle ( CTA), and the angles between Whiteside line and the PCL ( posterior condylar line, WPCL), SEA (surgical epicondylar angle, WSEA), CEA (clinical epicondylar angle, CEA) were measured.Results The mFTA, WPCL, WSEA, and WCEA in the varus group were larger than those of the normal group , while the aMPTA, PCA, and CTA were smaller .The aMPTA, PCA, CTA, WPCL, WSEA, and WCEA in the valgus group were larger than those of the normal group, while the mFTA and aLDFA were smaller than those of the normal group (all P<0.05).The PCA in the varus group was negatively correlated with mFTA ( r=-0.555 ) , and positively correlated with the aMPTA (r=0.450); the PCA in the valgus group was negatively correlated with the mFTA (r=-0.614) and aLDFA (r=-0.719), all P<0.05.When mFTA gradually increased to 15 °in the varus group, the PCA and CTA decreased , all P<0.05.Conclusions The Whiteside line had a lateral shifting trend in the osteoarthritic knees .The PCA, and CTA were smaller in the varus knees and were correlated with mFTA and aMPTA;the PCA, and CTA were larger in the valgus knees and were associated with mFTA and aLDFA .
