实用骨科杂志
實用骨科雜誌
실용골과잡지
JOURNAL OF PRACTICAL ORTHOPEDICS
2015年
8期
702-705
,共4页
殷钦%宋希玺%丛锐军%李西凡%陶坤
慇欽%宋希璽%叢銳軍%李西凡%陶坤
은흠%송희새%총예군%리서범%도곤
全膝关节置换手术%假体旋转对线%膝内翻畸形%影像学研究
全膝關節置換手術%假體鏇轉對線%膝內翻畸形%影像學研究
전슬관절치환수술%가체선전대선%슬내번기형%영상학연구
total knee arthroplasty%rational alignment of implant%knee varus deformity%image analyzes
目的：通过对不同膝关节 CT 扫描图像的比较和分析，评估股骨远端假体旋转对位标志在内翻畸形膝关节中的可靠性。方法研究包括108侧膝关节，行薄层 CT 扫描，分为轻度内翻组（内翻小于等于20°）、重度内翻组（内翻大于20°）、正常对照组。在 CT 图像上定位外髁经股骨上髁轴（surgical transepicondylar axis，SEA）、前后轴（antero-posterior axis，AP axis）、后髁轴（posterior condylar line，PCL）和股骨前轴（anterior femoral axis，AFA）。分别测量 AP ax-is、PCL 和 AFA 相对于 SEA 的角度，并在不同亚组之间比较各个角度的差异。结果重度内翻组膝关节 PCA 值较正常对照组和轻度内翻组差异均有统计学意义，轻度内翻组和正常对照组之间 PCA 值差异无统计学意义。ASA 和 FSA值在三组之间差异均无统计学意义。结论 AP axis 和 AFA 较 PCL 受重度内翻畸形影响较小。但 AP axis 变异较大，作为参考标志时要谨慎，股骨前轴较稳定，膝关节伴内翻畸形时可以参照此轴放置假体。
目的：通過對不同膝關節 CT 掃描圖像的比較和分析，評估股骨遠耑假體鏇轉對位標誌在內翻畸形膝關節中的可靠性。方法研究包括108側膝關節，行薄層 CT 掃描，分為輕度內翻組（內翻小于等于20°）、重度內翻組（內翻大于20°）、正常對照組。在 CT 圖像上定位外髁經股骨上髁軸（surgical transepicondylar axis，SEA）、前後軸（antero-posterior axis，AP axis）、後髁軸（posterior condylar line，PCL）和股骨前軸（anterior femoral axis，AFA）。分彆測量 AP ax-is、PCL 和 AFA 相對于 SEA 的角度，併在不同亞組之間比較各箇角度的差異。結果重度內翻組膝關節 PCA 值較正常對照組和輕度內翻組差異均有統計學意義，輕度內翻組和正常對照組之間 PCA 值差異無統計學意義。ASA 和 FSA值在三組之間差異均無統計學意義。結論 AP axis 和 AFA 較 PCL 受重度內翻畸形影響較小。但 AP axis 變異較大，作為參攷標誌時要謹慎，股骨前軸較穩定，膝關節伴內翻畸形時可以參照此軸放置假體。
목적：통과대불동슬관절 CT 소묘도상적비교화분석，평고고골원단가체선전대위표지재내번기형슬관절중적가고성。방법연구포괄108측슬관절，행박층 CT 소묘，분위경도내번조（내번소우등우20°）、중도내번조（내번대우20°）、정상대조조。재 CT 도상상정위외과경고골상과축（surgical transepicondylar axis，SEA）、전후축（antero-posterior axis，AP axis）、후과축（posterior condylar line，PCL）화고골전축（anterior femoral axis，AFA）。분별측량 AP ax-is、PCL 화 AFA 상대우 SEA 적각도，병재불동아조지간비교각개각도적차이。결과중도내번조슬관절 PCA 치교정상대조조화경도내번조차이균유통계학의의，경도내번조화정상대조조지간 PCA 치차이무통계학의의。ASA 화 FSA치재삼조지간차이균무통계학의의。결론 AP axis 화 AFA 교 PCL 수중도내번기형영향교소。단 AP axis 변이교대，작위삼고표지시요근신，고골전축교은정，슬관절반내번기형시가이삼조차축방치가체。
Objective To analyze the rotational alignment of distal femoral on CT scans of the normal knees and osteoar-thritis knees with varus deformities,and to identify whether PCL,AP axis and FAT line are reliable for determining rotational a-lignment in varus knees. Methods One hundred and eight knees underwent CT were included in this study,and were divided into three groups(Group A,normal knees,n = 30;Group B,mild varus,n = 47;Group C,severe varus,n = 31). SEA,PCL,AP axis and AFA were located respectively in different slices,then PCA,ASA and FSA were measured,and these angles were com-pared between 3 groups. Results The values of PCA in Group C was significantly less than that in Group A and Group B,but there was no statistical differences between Group A and Group B. There were no significant differences between the three groups in the values of ASA and FSA. Conclusion This study indicates that the PCA is not reliable for femoral rotational a-lignment in severe varus knees. ASA and FSA are not affected by osteoarthritis,however the variation of values suggests that the AP axis should be used with caution,and the AFA is a stable axis as a rotational assessment guide.
