国人股骨远端旋转轴线的影像学研究及其临床意义

发布时间：2018-03-16 20:12

本文选题：股骨　切入点：关节成形术　出处：《中国骨伤》2016年01期 　论文类型：期刊论文

【摘要】：目的 :探讨全膝关节置换术中股骨远端旋转轴线的临床应用价值。方法 :成年国人86例(106膝),男47例(53膝),女39例(53膝);左54膝,右52膝。应用CT垂直于股骨机械轴对股骨远端进行薄层扫描,将获取的通过股骨远端内外上髁的横断面CT图像输入电脑,标识、测量前后轴线(APL)与外科髁上轴(STEA)的外侧夹角(ATA),APL与后髁轴线(PCL)的外侧夹角(APA),APL的垂线(APLP)与PCL的夹角(A-PA),后髁角(PCA),髁扭转角(CTA),CTEA与STEA之间的夹角(CSA)。按性别和侧别分组,分析各角度两组间差异,比较CTA、A-PA、PCA、PT角(胫骨平台内翻角)、常数3°之间以及ATA、APA与常数90°间差异,分别对A-PA、PCA与CTA行线性回归分析,用直线回归评定STEA、CTEA、PCL、APL及APLP之间的相关程度。结果:ATA平均(89.79±1.22)°,APA为(84.84±1.83)°,A-PA为(5.16±1.83)°,PCA为(4.80±1.23)°,CTA为(8.23±1.40)°,CSA为(3.45±0.68)°,以上各角度除CSA性别间差异有统计学意义外,余角度在性别和侧别间差异均无统计学意义。PT角、PCA及A-PA间差异无统计学意义,但分别与CTA、常数3°比较,差异均有统计学意义。常数90°与ATA比较差异无统计学意义,与APA比较差异有统计学意义。PCA与CTA、PCA与A-PA、A-PA与CTA均存在明显相关性。STEA与CTEA、STEA与APL、PCL与STEA均明显相关。APLP和APL均与PCL相关,PCL与CTEA无明显相关性。结论:国人TKA中,股骨后髁的外旋截骨角度应为5°,方能获得更满意的股骨假体旋转对线。STEA与CTEA是两条性质完全不同的轴线,不能以平行于CTEA作为旋转力线的参考标志,国人股骨远端旋转轴之间的可靠性,分别为STEA㧐APL㧐PCL,STEA是股骨远端旋转轴线中最可靠的定位标志。
[Abstract]:Objective: to investigate the clinical application value of rotation axis of distal femur in total knee arthroplasty methods: 86 adult Chinese patients (47 males 53 knees, 39 females 53 knees), left 54 knees, Right 52 knees. The distal femur was scanned by CT perpendicular to the mechanical axis of the femur. The computed tomography (CT) images obtained through the medial and lateral epicondyle of the distal femur were input to the computer for identification. The lateral angle between the anterior and posterior axis (PCL) and the lateral angle between the anterior and posterior condylar axis (PCL) and the posterior condylar angle (PCL) and the angle between the condylar angle (PCL) and the condylar torsion angle (STEA) were measured. The angle between STEA and the posterior condylar angle was classified according to sex and side. The differences between the two groups were analyzed, and the differences of the angle (tibial plateau varus angle, constant 3 掳and ATAA APA and constant 90 掳) were compared. The linear regression analysis was performed between A-PAPA and CTA, respectively. The correlation between APLP and APLP was evaluated by linear regression analysis. Results the average APLP was 89.79 卤1.22 掳APLP and 5.16 卤1.83 掳APLP. There were significant differences between the above angles except CSA gender, and the correlation between them was 8.23 卤1.40 掳and 3.45 卤0.68 掳, respectively. There was no significant difference between sex and lateral angle. There was no significant difference between PCA and A-PA in PT angle, but there was significant difference between PCA and A-PA, but there was no significant difference between constant 90 掳and ATA. Compared with APA, there was significant correlation between PCA and CTAPCA and A-PAAPA and CTA. There was no significant correlation between STEA and STEA and between STEA and STEA. Conclusion: in Chinese TKA, there is no significant correlation between APL and PCL. Conclusion: in Chinese TKA, there is no significant correlation between STEA and STEA. Conclusion: in Chinese TKA, there is no significant correlation between STEA and STEA. Conclusion: in Chinese TKA, there is no significant correlation between APL and PCL. The angle of external rotation osteotomy of the posterior femoral condyle should be 5 掳, so as to obtain a more satisfactory rotation alignment of femoral prosthesis. STEA and CTEA are two axes with completely different properties. Parallel to CTEA can not be used as the reference mark of rotational force line. The reliability of the rotation axis of the distal femur in Chinese is STEAA? APL? The PCL-STEA is the most reliable location marker in the rotation axis of distal femur.
【作者单位】：兰溪市人民医院骨科;苏州大学附属第一医院关节外科;
【分类号】：R687.3

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