摘要
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(anteroposterior axis,AP axis)、后髁轴(posterior condylar line,PCL)和股骨前轴(anterior femoral axis,AFA)。分别测量AP axis、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。
Objective To analyze the rotational alignment of distal femoral on CT scans of the normal knees and osteoarthritis knees with varus deformities,and to identify whether PCL,AP axis and FAT line are reliable for determining rotational alignment 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 compared 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 alignment 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.
出处
《实用骨科杂志》
2015年第8期702-705,共4页
Journal of Practical Orthopaedics
基金
国家自然科学基金项目(91000808)
关键词
全膝关节置换手术
假体旋转对线
膝内翻畸形
影像学研究
total knee arthroplasty
rational alignment of implant
knee varus deformity
image analyzes
