摘要
目的探讨全膝关节置换术(TKA)中直接测量股骨后髁角(PCA)的新方法,并研究国人膝骨性关节炎患者股骨后髁角的特点。方法研制股骨后髁角测定仪。对67例(70膝)在我院行TKA术的膝骨关节炎患者,术中用股骨后髁角测定仪测量后髁角;比较膝骨关节炎患者后髁角与国外测量结果的差异。结果该组PCA为5.0°±2.1°,与美国研究结果(3.7°±2.2°)之间存在显著统计学差异(t=3.159,P<0.005)。结论股骨后髁角测定仪提供了术中测量PCA的新方法,为股骨假体旋转对线提供依据;国人骨关节炎患者PCA与欧美的存在显著统计学差异,TKA术中应据每一个体所测得PCA确定股骨假体旋转角度。
Objective To develop a new method of measuring the posterior condylar angle （PCA） interoperatively, and measure the PCA of arthritic knees, and investigate the feature of the rotational alignment of the distal femur in southern Chinese people with osteoarthdtic knees. Methods From July 2008 to March 2010, the PCA was measured directly in 70 osteoarthritic knees undergoing total knee arthroplasty with the PCA conimeter made by ourselves. There were 67 patients including 11 males and 56 females, and the average age was 66.7 years （ranging 50 to 78 years）, 33 left knees and 27 right knees. The value of the PCA we obtained was compared with that Griffin obtained using student＇s t test. Results The value of the PCA we obtained was 5.0° ± 2.1°, and was significantly different from that Griffin obtained （3.7°± 2.2°） （t=-3.159, P 〈0.005）. Conclusions The PCA conimeter offers a new way to measure the value of the PCA directly in arthritic knees undergoing total knee arthroplasty, and helps to determine the rotational alignment of the femoral component. The PCA was significantly greater in Chinese osteoarthritic knees than in western osteoarthritic knees. Given the standard deviations and ranges of values noted, the line 3° of external rotation off the posterior condyles has potentially unreliable reference for femoral component rotation in some knees. The transepicondylar axis is the most consistent and recreatable landmark for appropriate femoral component positioning. The femoral component rotation should be individualized to particular deformity of a given knee to obtain rotational alignment symmetry.
出处
《临床医学工程》
2012年第2期165-167,共3页
Clinical Medicine & Engineering
关键词
关节成形术
膝
置换
股骨后髁角
股骨上髁轴
Femoral component rotation
Total knee arthroplasty
, Osteoarthritic knee
Posterior condylar angle
Tmnsepicondylar axis
